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
...Diagnosis...
...h abdominal pain, weight loss, and food...
...aking a diagnosis of CMI in patients with the...
...recommend using the mesenteric duplex ultrasound e...
...ommend using CT arteriography (CTA)...
Treatment
...Treatment...
...Indications...
...vascularization in patients with CMI...
...t total parenteral nutrition is not an a...
...t the SMA is the primary target for...
...e suggest that the celiac axis and inferior mesen...
...patients with symptoms consistent with CMI an...
...with symptoms consistent with CMI and occlusive...
...at asymptomatic patients with severe MAOD be close...
...with severe MAOD involving the SMA undergoin...
...n patients with combined MAOD and mes...
...Choice of Treatment...
...eatment for patients with CMI shou...
...recommend endovascular revascularization a...
...nd reserving open surgical revascula...
...Preoperative Evalua...
...ndergoing revascularization for CMI should be o...
...ommend obtaining a CTA to delineate the v...
E...
...est using balloon-expandable covered in...
...Open Surgical...
...open surgical revascularization for...
Follow-up
...Follow-up...
...Surveillance and Reme...
...going revascularization for CMI should...
...be followed in the outpatient setting afte...
...surveillance with mesenteric duplex ul...
...performing a CTA or catheter-based arteriograms...
...recurrent symptoms of CMI, we recommend remedial...
...select patients with asymptomatic recurr...
...st that the choice of revascularization for...