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
Diagnosi...
...nts with abdominal pain, weight loss,...
...ommend making a diagnosis of CMI in patients with...
...ng the mesenteric duplex ultrasound examination a...
...mend using CT arteriography (CTA) as the pr...
Treatment
...atment...
...ions for Treatment...
...e recommend revascularization in patien...
...mmend that total parenteral nutrition is no...
...the SMA is the primary target for revascul...
...that the celiac axis and inferior mesenteri...
...with symptoms consistent with CMI and...
In patients with symptoms consistent with CMI and...
...mmend that asymptomatic patients wit...
...h severe MAOD involving the SMA under...
...th combined MAOD and mesenteric art...
Choice of Treatment
...e of treatment for patients with CM...
...e recommend endovascular revascularization as t...
...e recommend reserving open surgical revascu...
Preoperative Evaluat...
...ing revascularization for CMI should be opt...
...ommend obtaining a CTA to delineate the va...
Endovascular Revascularizatio...
...uggest using balloon-expandable covered intralum...
...en Surgical Revasculari...
...of open surgical revascularization f...
Follow-up
...low-up
Surveillance and Remed...
...undergoing revascularization for C...
...ould be followed in the outpatient sett...
...illance with mesenteric duplex ult...
...performing a CTA or catheter-based arteriograms to...
...s with recurrent symptoms of CMI, we recommend r...
...patients with asymptomatic recurrent steno...
...t the choice of revascularization for rec...