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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

620

Advancements in Treatment Strategies for Chronic Mesenteric Ischemia: A Comprehensive Review

Genti Xhepa1,2, Andrea Vanzulli3, Lucilla Violetta Sciacqua3

  • 1Istituto Di Imaging ella Svizzera Italiana (IIMSI), Clinica Di Radiologia, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland.

Journal of Clinical Medicine
|November 25, 2023
PubMed

Insights

Chronic mesenteric ischemia (CMI) is a condition affecting blood flow to the intestines. Primary stenting (PMAS) is preferred over angioplasty (PTA) for treating atherosclerotic mesenteric artery stenosis.

Area of Science:

  • Vascular Surgery
  • Gastroenterology
  • Interventional Cardiology

Background:

  • Chronic mesenteric ischemia (CMI) results from inadequate intestinal blood flow post-meal, causing oxygen supply-demand imbalance.
  • Mesenteric artery occlusive disease (MAOD) is common in the elderly, but CMI diagnosis is often delayed due to varied symptoms.
  • Surgical treatment for superior mesenteric artery (SMA) occlusive lesions began in 1957, with endovascular revascularization (ER) introduced in 1980.

Purpose of the Study:

  • To review current treatment strategies for chronic mesenteric ischemia (CMI).
  • To compare endovascular revascularization (ER) methods, specifically percutaneous transluminal angioplasty (PTA) and primary stenting (PMAS).
  • To highlight the need for further research into optimal treatment for atherosclerotic mesenteric artery stenosis.

Main Methods:

  • Literature review of endovascular revascularization (ER) techniques for CMI.
  • Analysis of expert consensus on treatment for atherosclerotic mesenteric artery stenosis.
  • Identification of research gaps in CMI management.

Main Results:

  • Endovascular revascularization (ER) includes percutaneous transluminal angioplasty (PTA) and primary stenting (PMAS).
  • Expert consensus favors primary stenting (PMAS) over PTA alone for atherosclerotic mesenteric artery stenosis, despite limited evidence quality.
  • Further randomized trials are needed to compare stent types.

Conclusions:

  • Primary stenting (PMAS) is the preferred endovascular approach for atherosclerotic mesenteric artery stenosis causing CMI.
  • High-quality randomized controlled trials are essential to compare different stent types (e.g., covered vs. bare metal) for CMI.
  • Future research should focus on optimizing efficacy, patency rates, and long-term outcomes in CMI patients undergoing ER.
Keywords:
chronic mesenteric ischemiaendovascular revascularization (ER)percutaneous transluminal angioplasty (PTA)primary stenting (PMAS)revascularizationreviewsuperior mesenteric arterytreatment

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