TY - JOUR
T1 - Clinical management of chronic mesenteric ischemia
AU - Dutch Mesenteric Ischemia Study
AU - van Dijk, Louisa J. D.
AU - van Noord, Desiree
AU - de Vries, Annemarie C.
AU - Kolkman, Jeroen J.
AU - Geelkerken, Robert H.
AU - Verhagen, Hence J. M.
AU - Moelker, Adriaan
AU - Bruno, Marco J.
AU - Balm, Ron
AU - de Borst, Gert Jan
AU - Blauw, Juliette T.
AU - Bakker, Olaf J.
AU - Buscher, Hessel C. J. L.
AU - Fioole, Bram
AU - Hamming, Jaap F.
AU - Harki, Jihan
AU - van den Heuvel, Daniel A. F.
AU - van Hattum, Eline S.
AU - Hinnen, Jan Willem
AU - van der Laan, Maarten J.
AU - Lenaerts, Kaatje
AU - Peppelenbosch, Maikel P.
AU - van Petersen, Andre S.
AU - Rijnja, Pepijn
AU - van der Schaar, Peter J.
AU - Terlouw, Luke G.
AU - de Vries, Jean Paul P. M.
AU - Vroegindeweij, Dammis
PY - 2019/3
Y1 - 2019/3
N2 - This review provides an overview on the clinical management of chronic mesenteric ischemia (CMI). CMI is defined as insufficient blood supply to the gastrointestinal tract, most often caused by atherosclerotic stenosis of one or more mesenteric arteries. Patients classically present with postprandial abdominal pain and weight loss. However, patients may present with, atypically, symptoms such as abdominal discomfort, nausea, vomiting, diarrhea or constipation. Early consideration and diagnosis of CMI is important to timely treat, to improve quality of life and to prevent acute-on-chronic mesenteric ischemia. The diagnosis of CMI is based on the triad of clinical symptoms, radiological evaluation of the mesenteric vasculature and if available, functional assessment of mucosal ischemia. Multidisciplinary consensus on the diagnosis of CMI is of paramount importance to adequately select patients for treatment. Patients with a consensus diagnosis of single-vessel or multi-vessel atherosclerotic CMI are preferably treated with endovascular revascularization.
AB - This review provides an overview on the clinical management of chronic mesenteric ischemia (CMI). CMI is defined as insufficient blood supply to the gastrointestinal tract, most often caused by atherosclerotic stenosis of one or more mesenteric arteries. Patients classically present with postprandial abdominal pain and weight loss. However, patients may present with, atypically, symptoms such as abdominal discomfort, nausea, vomiting, diarrhea or constipation. Early consideration and diagnosis of CMI is important to timely treat, to improve quality of life and to prevent acute-on-chronic mesenteric ischemia. The diagnosis of CMI is based on the triad of clinical symptoms, radiological evaluation of the mesenteric vasculature and if available, functional assessment of mucosal ischemia. Multidisciplinary consensus on the diagnosis of CMI is of paramount importance to adequately select patients for treatment. Patients with a consensus diagnosis of single-vessel or multi-vessel atherosclerotic CMI are preferably treated with endovascular revascularization.
KW - Chronic mesenteric ischemia
KW - atherosclerosis
KW - median arcuate ligament syndrome
KW - computed tomography angiography
KW - endovascular therapy
KW - GASTRIC EXERCISE TONOMETRY
KW - VISIBLE-LIGHT SPECTROSCOPY
KW - ARTERY
KW - REVASCULARIZATION
KW - MORTALITY
KW - DIAGNOSIS
KW - STENOSIS
U2 - 10.1177/2050640618817698
DO - 10.1177/2050640618817698
M3 - Review article
SN - 2050-6406
VL - 7
SP - 179
EP - 188
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 2
ER -