Abstract
Superior mesenteric artery occlusion caused by atherosclerosis superimposed with long segment thrombosis in a 54 year old male who previously underwent a resection-anastomosis and thrombectomy procedure was treated by extra anatomic bypass grafting. The abdominal aorta could not be used for inflow due to marked adhesions from previous surgery and severe atherosclerotic changes in the wall. A vein graft was bypassed from the right common iliac artery to the superior mesenteric artery to provide effective reperfusion.