A 70 year old male smoker presented with an 18-month history of postprandial abdominal pain, vomiting, food aversion, and pro-found weight loss. Extensive gastroenterologic evaluation was unrevealing. Biplanar abdominal aortography confirmed celiac and superior mesenteric artery occlusion. Revascularization was ac-complished by aortoceliac and aorto-SMA bifurcated bypass grafting, which resulted in resolution of symptoms