Chronic mesenteric ischemia: diagnosis and management

Prog Cardiovasc Dis. 2011 Jul-Aug;54(1):36-40. doi: 10.1016/j.pcad.2011.04.005.


Chronic mesenteric ischemia (CMI) is the most common vascular disorder involving the intestines, however it is unusual in clinical practice. The redundancy of the visceral circulation with multiple interconnections between the superior mesenteric artery (SMA) and the inferior mesenteric artery (IMA) is the most likely explanation for the infrequent occurrence of CMI in clinical practice. Atherosclerosis is by the far the most common etiology of CMI. The increased utilization of diagnostic abdominal cross-sectional imaging has increased the recognition of atherosclerotic mesenteric stenoses. CMI is a clinical diagnosis, based upon symptoms and consistent anatomic findings. The classic setting for CMI is a female patient presenting with post-prandial abdominal discomfort that results in significant weight loss. Endovascular therapy with stenting has become the most common method chosen for revascularization having replaced open surgery with its associated morbidity and mortality.

Publication types

  • Review

MeSH terms

  • Diagnostic Imaging / methods
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / mortality
  • Humans
  • Ischemia / diagnosis
  • Ischemia / mortality
  • Ischemia / therapy
  • Mesenteric Ischemia
  • Mesenteric Vascular Occlusion / diagnosis*
  • Mesenteric Vascular Occlusion / mortality
  • Mesenteric Vascular Occlusion / therapy*
  • Patient Selection
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors
  • Stents
  • Treatment Outcome
  • Vascular Diseases / diagnosis
  • Vascular Diseases / mortality
  • Vascular Diseases / therapy
  • Vascular Surgical Procedures* / adverse effects
  • Vascular Surgical Procedures* / mortality