Role of Endovascular Intervention in Management of Chronic Mesenteric Ischemia
Open accessAbstract
Background: Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization (SR) or endovascular revascularization (ER). - The management of symptomatic atherosclerotic chronic mesenteric ischemia which is an uncommon disorder is challenging. Although surgical revascularization (SR) has been considered as the gold standard since its introduction based on observational data published over the last 25 years, there has been increased use of endovascular revascularization (ER) in treating CMI. This review seeks to assess, through the available literature, the role of endovascular intervention in management of chronic mesenteric ischemia and determine the benefits as well as the withdraws of the intervention. Objective: to assess the role of endovascular intervention in management of chronic mesenteric ischemia and determine the efficacy (in terms of patency), and safety, (in terms of perioperative morbidity and mortality) of endovascular revascularization (ER) in treating patients with CMI, using the currently available literature and applying a systematic review and meta-analysis. Methods: The review is a meta-analysis and systematic review that included randomized controlled trials (RCT), case series and retrospective studies which studied the role on endovascular techniques of management of chronic mesenteric ischemia. Results: Abstracts of articles that were published from 2000-2020 identified using the search strategy were reviewed and articles that appear to fulfill the inclusion criteria were retrieved in full text. Data on at least one of the outcome measures was included in the study. This study included published papers and research written in English language that published from 2000-2020. We excluded papers not written in English, studies before 2000 and case report study. Conclusion: Endovascular management of chronic mesenteric ischemia is a feasible strategy associated with increased technical and clinical success rate and patency rates. It also associated with low rate of mortality and complications. Restenosis and symptom recurrence were reported in more than 20% of the patients which necessitating preoperative assessment of abdominal pain, good selection of patients and improving the endovascular technique.
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Endovascular approaches have lower rates of in-hospital cardiac and cerebrovascular events, shorter hospital stays, lower in-hospital complications, and better cost-effectiveness than surgical revascularization.
“endovascular approaches have lower rates of in-hospital cardiac and cerebrovascular events, shorter hospital stays, lower in-hospital complications, and better cost-effectiveness [70,71,77].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [70]
The Conclusion (p. i122) says endovascular management of chronic mesenteric ischemia is associated with a low rate of complications. It does not compare those rates with surgical revascularization or report in-hospital cardiac or cerebrovascular events, hospital stays, or cost-effectiveness. (LLM, conf=0.84)
Experimental — accuracy not yet measuredRestenosis may occur in up to 20-40% of patients and require reintervention.
“Post-revascularization, most patients maintain symptom relief for 5–10 years, but restenosis may occur in up to 20–40% of patients and require reintervention [70,77].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [70]
The paper’s Conclusion (p. i122) reports restenosis and symptom recurrence in more than 20% of patients after endovascular management of chronic mesenteric ischemia. It does not give a 40% upper figure or say that restenosis required reintervention. (LLM, conf=0.87)
Experimental — accuracy not yet measuredEndovascular revascularization can have similar perioperative outcomes to open surgery but higher rates of late technical failure with symptom recurrence and need for reintervention.
“comparative studies have suggested that endovascular revascularization can have similar perioperative outcomes to traditional open surgical interventions but demonstrate higher rates of late technical failure with symptom recurrence and need for reintervention [35,70].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [70]
The Conclusion (p. i122) reports low mortality and complication rates after endovascular treatment, but also restenosis and symptom recurrence in more than 20% of patients. It does not establish similar perioperative outcomes versus open surgery, higher late failure rates relative to surgery, or a need for reintervention. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPost-revascularization, most patients maintain symptom relief for 5-10 years.
“Post-revascularization, most patients maintain symptom relief for 5–10 years, but restenosis may occur in up to 20–40% of patients and require reintervention [70,77].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [70]
The Conclusion (QJM supplement, p. i122) reports clinical success after endovascular treatment of chronic mesenteric ischemia, which supports symptom improvement. It gives no 5–10-year follow-up or estimate of how many patients maintain relief for that period; it instead reports symptom recurrence in more than 20% of patients. (LLM, conf=0.85)
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Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review
Gries, J. J., Sakamoto, T., Chen, B., Virk, H. U. H., Alam, M., & Krittanawong, C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051217 · Cited by 19 · see citing works
“As the revascularization strategies of acute and chronic mesenteric ischemia continue to evolve and the popularity of endovascularization techniques increases, so does the importance of risk stratification and prognostication.”
BackgroundRenal and Mesenteric Artery Intervention
Soto, J. T., Shah, K. B., & White, C. J. (2025) · Interventional Cardiology Clinics · doi:10.1016/j.iccl.2024.11.007
- Authors
- Ali, A. A.-R. N.-E. S., Farahat, M. S., Elmaleh, H. M., & Fakhr, M. E.
- Affiliations
- Ain Shams University (EG)
- Corresponding author
- Ali, Abd Al-Rahman Najm-Eldin Sultan
- Venue
- QJM: An International Journal of Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2023-06-01
- Volume
- 116
- Issue
- Supplement_1
- ISSN
- 0033-5622 (ISSN-L)
- 1460-2725
- 1460-2393
- OpenAlex
- W4386093060
- Cited by
- 2
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- QJM (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
- Keywords
- chronic mesenteric ischemia, endovascular revascularization, surgical revascularization, stent graft patency, restenosis, perioperative morbidity, patient selection
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