Visceral Artery Revascularization

Chronic mesenteric ischemia is predominantly diagnosed in women and the most often symptoms presented are the classic triad of abdominal pain, weight loss, and “food fear.” Most patients have advanced atherosclerosis affecting the ostia of at least two of the three mesenteric arteries. Advances in diagnostic imaging, endovascular treatment, and critical care management have resulted in significant improvement in outcomes. Endovascular therapy has become the first option for treatment in most patients. Open repair has been relegated to patients who fail endovascular therapy or are not candidates for it because of long-segment arterial occlusion or multiple failed endovascular re-interventions. This chapter summarizes the basic diagnostic and therapeutic concepts to deal with patients with mesenteric artery disease.