Endovascular Therapy for Chronic Mesenteric Ischemia.

OPINION STATEMENT: Chronic mesenteric ischemia (CMI) most commonly occurs as a consequence of multivessel atherosclerotic disease of the mesenteric vasculature. Risk factors include smoking, hypertension, dyslipidemia, and advanced age, and women are more commonly affected than men. The clinical presentation of CMI is characterized by postprandial abdominal pain and weight loss. Left untreated, patients often develop severe malnutrition. Current consensus guidelines recommend secondary prevention medications such as statins and aspirin for all patients with known atherosclerosis to reduce the risk of stroke and MI, but data specific to medical therapy in CMI are lacking. To date, no medical therapy has been proven to be effective in preventing the progression of mesenteric atherosclerosis. Revascularization through surgical bypass is associated with significant perioperative morbidity and mortality. The evolution of endovascular techniques and equipment has made catheter-based therapy a first-line option for revascularization in CMI.