Endovascular Treatment of Mesenteric Occlusive Disease

Mesenteric ischemia has been traditionally treated with open surgery. This carried a significant morbidity and mortality. Endovascular therapy use has been on the rise due to its popular use in treating atherosclerotic lesions. Endovascular therapy is very attractive due to its lower morbidity and mortality. However, patency and functional outcome in comparison to open surgery is still being scrutinized. Endovascular therapy use has surpassed open bypass surgery in treating chronic mesenteric ischemia. There are no randomized studies to compare the two treatment modalities. Endovascular therapy is an attractive first line of treatment in patients with mesenteric ischemia specially in the high risk patient with no evidence of bowel ischemia. Bypass should be entertained in patients who are good surgical candidates. Acute mesenteric ischemia could be treated by endovascular means but the assessment of bowel ischemia is still a challenge.