The management of chronic mesenteric ischaemia remains a compelling challenge for many vascular surgeons. Over the past four decades, several reports have demonstrated encouraging results following revascularisation of the splanchnic arteries. To this date, due to limited numbers, there have been no randomized trials on which we can base our current practise. In this series, we have demonstrated the benefits of a left thoracoabdominal approach for performing an antegrade bypass graft to the coeliac axis, in patients with severe mesenteric angina. Its low complication rate and excellent aortic vessel exposure make it a procedure of choice in expert centres.
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