The endovascular therapy of chronic mesenteric ischemia: how much have we known so far

The purpose of this paper is to collect and summarize the clinical evidence related to the endovascular therapy of chronic mesenteric ischemia. The relevant medical literature in English language were collected through Medline by inputting the subject headings, including 'mesenteric ischemia', 'balloon angioplasty', 'mesenteric stenting' and 'intestinal angina'. The medical documents which reported five or more cases receiving endovascular therapy were enrolled in our study for analysis. A total of 16 series with 328 cases altogether were thus obtained. The therapeutic indication for endovascular intervention in all patients was symptomatic mesenteric arterial stenosis. The technical successful rate was 91%. In 75% patients, the clinical symptoms disappeared after the procedure and repeated intervention was not needed. During the follow-up period, re-stenosis occurred in 28% patients. Complications developed in 9% patients, including dissection, distal embolus, infection, thrombosis, bleeding at puncture site, etc. The mortality at 30 days was 3%. Endovascular intervention is a safe treatment for chronic mesenteric stenosis or occlusion. Stent implantation technique carries a higher technical successful rate. However, there are still about one third patients who will probably develop re-stenosis. (authors)