CIRSE Standards of Practice for the Interventional Radiology Management of Acute and Chronic Arterial Mesenteric Ischaemia

Abstract

Purpose: Mesenteric ischaemia due to arterial occlusion, usually secondary to atherosclerosis or arterial thromboembolism, may be acute or chronic. Endovascular intervention is now the primary treatment based on its minimally invasive nature and lower in-hospital mortality. Open surgery is indicated in the presence of bowel necrosis, the diagnosis of which remains challenging. This document makes best-practice recommendations about the interventional radiology management of acute and chronic mesenteric ischaemia. Methods: The CIRSE Standards of Practice Committee established a writing group of six clinicians with internationally recognised expertise in the management of arterial mesenteric ischaemia. The writing group performed a pragmatic search on PubMed for relevant studies published in English in 2013–2024. The final recommendations were developed by consensus. Results: Endovascular interventions for arterial mesenteric ischaemia have very high technical success rates. Complication rates are lower than with open surgical revascularisation; however, patency times may be shorter. Patients must receive antiplatelet therapy and be monitored for recurrence.