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Updated: Jun 10, 2026

Multimodality Diagnosis of Mesenteric Ischemia
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Published on: July 21, 2023

Chronic mesenteric ischemia: endovascular versus open revascularization.

Prateek K Gupta1, Siobain M Horan, Kiran K Turaga

  • 1Department of Surgery, Creighton University, Omaha, Nebraska, USA.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|August 5, 2010
PubMed
Summary

Open revascularization for chronic mesenteric ischemia (CMI) offers superior long-term symptom control and vessel patency compared to endovascular procedures. However, open surgery has a higher complication rate, necessitating individualized treatment approaches.

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Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Medical Literature Review

Background:

  • Chronic mesenteric ischemia (CMI) presents complex clinical challenges.
  • Understanding treatment outcomes is crucial for patient management.

Purpose of the Study:

  • To review 20 years of literature on chronic mesenteric ischemia (CMI).
  • To compare the efficacy and outcomes of open versus endovascular treatment options for CMI.

Main Methods:

  • A comprehensive literature search was conducted on PubMed and EBSCOHost for English-language articles.
  • Data from 1939 patients (mean age 65) undergoing open surgery or endovascular repair were analyzed.
  • Patient data were pooled for categorical analysis.

Main Results:

  • Open surgery demonstrated significantly higher rates of symptom improvement (2.4x) and 5-year freedom from symptoms (4.4x) compared to endovascular procedures.
  • Long-term vessel patency (primary and assisted primary) was substantially greater with open revascularization.
  • Open surgery was associated with a higher complication rate (3.2x), but mortality differences were not significant.

Conclusions:

  • Open revascularization is superior to endovascular procedures for long-term CMI symptom control and vessel patency.
  • Patients undergoing open procedures face increased perioperative complications.
  • The choice of revascularization strategy should be individualized based on patient anatomy and physiology.