Endovascular Treatment of Chronic Mesenteric Ischemia in the Setting of Occlusive Superior Mesenteric Artery Lesions

Endovascular Management for Symptomatic Chronic Mesenteric Ischemia: A Single-Center Experience

“…Notably, a CA stent alone carries a high risk of recurrence. 21 In our series, 2-vessel mesenteric interventions are usually performed in selected patients with severe gastric ischemia who have a poor mesenteric network.…”

Chronic Mesenteric Ischemia: Clinical Diagnosis, Imaging Characteristics, and Endovascular Management

“…41 Goldman et al reviewed 54 patients after endovascular treatment; their results support the multifocal nature of CMI and the importance of SMA involvement as a risk factor for symptom recurrence. 6 When treatment of the SMA was deemed unnecessary, and treatment of only the CA was performed, symptom recurrence was significantly higher (50%: 8/16) compared with symptom recurrence after concurrent treatment of both vessels (21.2%: 8/31). In cases involving stenosis or occlusion of both the CA and SMA, prior studies involving open surgical revascularization suggested that revascularization of the SMA was sufficient for clinical improvement.…”

“…Based on the extensive collateral network, patients are not expected to have significant symptoms until two or more primary mesenteric arteries experience significant stenosis or occlusion, though exceptions to this rule do occur. 6 Given the often gradual and nonspecific nature of the symptoms of CMI and its low incidence, there is often a delay in diagnosis.…”

Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery

“…The crucial role of the SMA is indirectly supported by the overall better symptomatic relief noted when the SMA is revascularized, regardless of what other combination of vessels are treated or whether performed by an open or endovascular approach. Notably, Goldman et al 91 compared the outcomes associated with the endovascular treatment of CA alone vs SMA alone or the latter in combination with the CA. They found that the treatment of the CA alone was associated with the highest rate of symptomatic recurrence and concluded that the SMA was the key determinant of successful revascularization.…”