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
...iagnos...
...th abdominal pain, weight loss, and food fea...
...making a diagnosis of CMI in patients w...
...ng the mesenteric duplex ultrasound exa...
...d using CT arteriography (CTA) as the pr...
Treatment
...eatment...
...tions for Treatment...
...ascularization in patients with CMI to...
...at total parenteral nutrition is not an acceptabl...
...st that the SMA is the primary targ...
...gest that the celiac axis and inferior...
...s with symptoms consistent with CM...
...patients with symptoms consistent with CM...
...ommend that asymptomatic patients with seve...
...ts with severe MAOD involving the SMA undergoin...
...ents with combined MAOD and mesenteric artery a...
...oice of Treatme...
The choice of treatment for patients with CM...
...nd endovascular revascularization as the initial...
...recommend reserving open surgical rev...
...erative Evaluatio...
...s undergoing revascularization for...
...ecommend obtaining a CTA to delineate...
...ndovascular Revascularizati...
...ggest using balloon-expandable covered...
...urgical Revascularization...
The choice of open surgical revascularization fo...
Follow-up
...ollow-up...
...rveillance and Remedia...
...s undergoing revascularization for CM...
...should be followed in the outpatient setti...
...rveillance with mesenteric duplex ultrasou...
...d performing a CTA or catheter-bas...
...patients with recurrent symptoms of CMI, we recomm...
...ts with asymptomatic recurrent steno...
...ggest that the choice of revasculariz...