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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

Chronic mesenteric ischemia: diagnosis and management

Christopher J White1

  • 1Department of Cardiovascular Diseases, The John Ochsner Heart & Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA 70121, USA. cwhite@ochsner.org

Progress in Cardiovascular Diseases
|July 5, 2011
PubMed

Insights

Chronic mesenteric ischemia (CMI), a rare vascular intestinal disorder, is often caused by atherosclerosis. Diagnosis relies on symptoms and imaging, with endovascular stenting now the preferred treatment over open surgery.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Chronic mesenteric ischemia (CMI) is the most common vascular intestinal disorder, yet infrequently diagnosed.
  • The visceral circulation's extensive redundancy between the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) contributes to its rarity.
  • Atherosclerosis is the predominant etiology of CMI.

Purpose of the Study:

  • To review the clinical presentation, diagnosis, and management of chronic mesenteric ischemia.
  • To highlight the increasing recognition of atherosclerotic mesenteric stenoses due to advanced imaging.
  • To discuss the shift in treatment paradigms from open surgery to endovascular interventions.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for CMI.
  • Analysis of the role of cross-sectional imaging in identifying mesenteric stenoses.
  • Evaluation of treatment outcomes for endovascular therapy versus open surgery.

Main Results:

  • CMI diagnosis is based on characteristic symptoms and anatomical findings.
  • Post-prandial abdominal discomfort and weight loss are classic symptoms, particularly in female patients.
  • Endovascular stenting is now the most common revascularization method, superseding open surgery due to lower morbidity and mortality.

Conclusions:

  • Atherosclerotic CMI is increasingly recognized due to improved imaging techniques.
  • Endovascular therapy offers a safer and more effective revascularization option for CMI.
  • Understanding the clinical and anatomical features is crucial for timely diagnosis and management of CMI.

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