Chronic Mesenteric Ischemia
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
...n patients with abdominal pain, weight loss, an...
...ommend making a diagnosis of CMI in pa...
...recommend using the mesenteric duplex ultrasound...
...ng CT arteriography (CTA) as the preferred...
Treatment
...Treat...
...Indic...
...evascularization in patients with...
...end that total parenteral nutrition is...
...ggest that the SMA is the primary ta...
...the celiac axis and inferior mesenteric...
...n patients with symptoms consistent w...
...ith symptoms consistent with CMI an...
...mend that asymptomatic patients wit...
...patients with severe MAOD involving t...
...h combined MAOD and mesenteric artery aneurysms, w...
...Choice of Treatment...
...e choice of treatment for patients...
...endovascular revascularization as the initi...
...commend reserving open surgical revasculariza...
...Preo...
...atients undergoing revascularization...
...obtaining a CTA to delineate the vascular a...
...Endov...
...ng balloon-expandable covered intraluminal st...
...Open Surgical Revasc...
...of open surgical revascularization...
Follow-up
...Follow-up
...Surveillance and Reme...
...s undergoing revascularization for CMI sh...
...should be followed in the outpatient setting aft...
...surveillance with mesenteric duplex ultrasoun...
...mend performing a CTA or catheter-b...
...th recurrent symptoms of CMI, we recommen...
...select patients with asymptomatic recurrent...
We suggest that the choice of revasculariza...