Chronic gastrointestinal ischaemia: shifting paradigms

Area of Science:

• Gastroenterology
• Vascular Surgery
• Diagnostic Imaging

Background:

• Chronic gastrointestinal ischaemia (CGI) is often diagnosed late due to non-specific symptoms.
• The classical triad of 'abdominal angina' is present in a minority of patients.
• Previous understanding underestimated CGI prevalence and symptom variability.

Purpose of the Study:

• To review current insights into the epidemiology and pathophysiology of CGI.
• To highlight advancements in the diagnosis and treatment of CGI.
• To inform clinicians about updated concepts regarding CGI.

Main Methods:

• Review of recent clinical research and focus group findings.
• Incorporation of data from advanced imaging techniques (e.g., CT-angiography).
• Consideration of new functional tests for mucosal perfusion and endovascular stenting options.

Main Results:

• CGI is more prevalent than previously thought, affecting patients with single- and multi-vessel disease.
• Symptom presentation is broader than the classical triad.
• Endovascular or surgical revascularization yields positive long-term outcomes in a significant proportion of patients.

Conclusions:

• Clinicians must be aware of the updated understanding of CGI prevalence and presentation.
• Modern diagnostic tools and revascularization techniques improve patient outcomes.
• A comprehensive approach integrating new insights is crucial for managing CGI.