Chronic Mesenteric Ischemia

Publication Date: January 1, 2021

Key Points

Key Points

  • Chronic mesenteric ischemia (CMI) is caused by the failure to achieve postprandial intestinal blood flow resulting in an imbalance between the supply and demand for oxygen and other metabolites.
  • This adverse hemodynamic event is typically caused by atherosclerotic occlusive disease at the orifices of the mesenteric vessels.

Diagnosis

...agnosis

...h abdominal pain, weight loss, and food...


...end making a diagnosis of CMI in patients with th...


...recommend using the mesenteric dup...


...using CT arteriography (CTA) as th...


Treatment

...eatmen...

Indications for Treatm...

...end revascularization in patients wit...

...d that total parenteral nutrition is not an a...

...suggest that the SMA is the primary ta...

We suggest that the celiac axis and infer...

...h symptoms consistent with CMI and occlusive...

...n patients with symptoms consisten...

...that asymptomatic patients with se...

...n patients with severe MAOD involving the SM...

...ents with combined MAOD and mesenteric arte...


...hoice of Treat...

...hoice of treatment for patients with...

...mend endovascular revascularization as the initial...

...erving open surgical revascularization for p...


...rative Evaluation...

...undergoing revascularization for CMI sh...

...commend obtaining a CTA to delineate the vasc...


...cular Revascularizatio...

...st using balloon-expandable covered intralumin...


...ical Revascularization...

...of open surgical revascularization fo...


Follow-up

...llow-u...

...veillance and Remediation...

Patients undergoing revascularization f...

...atients should be followed in the outpa...

...ggest surveillance with mesenteric duplex ultra...

...e recommend performing a CTA or cathet...

...ents with recurrent symptoms of CMI, we re...

...ect patients with asymptomatic recurrent...

...est that the choice of revasculari...