Endovascular management of acute and chronic arterial mesenteric ischaemia: A narrative review of evidence informing interventional radiology treatment
Abstract
Mesenteric ischaemia is a potentially life-threatening vascular disorder caused by impaired intestinal perfusion, with treatment selection requiring consideration of clinical presentation, bowel viability and lesion anatomy. This narrative review examines evidence informing interventional radiology decisions in arterial acute mesenteric ischaemia (AMI) and chronic mesenteric ischaemia (CMI). MEDLINE/PubMed was searched from inception to December 31, 2025, supplemented by reference-list screening and targeted guideline searches. Qualitative evidence synthesis considered patient selection, study design, adjunctive treatments, outcomes and follow-up. In AMI, endovascular techniques can restore perfusion, but predominantly retrospective evidence does not establish superiority over surgery in bowel preservation or survival. For CMI requiring revascularisation, European Society for Vascular Surgery guidelines recommend an initial endovascular approach, supported by Cardiovascular and Interventional Radiological Society of Europe consensus-based guidance. Observational comparisons associate endovascular treatment with lower perioperative morbidity, and surgery with less symptom recurrence. By linking individual treatment decisions to society guidance and supporting studies, this review complements existing comprehensive reviews and guidance documents. It distinguishes formal recommendations and consensus-based practice from technical feasibility and demonstrated comparative patient benefit, while identifying unresolved questions concerning AMI reperfusion strategies and device selection, in addition to antithrombotic therapy and restenosis management in CMI.
Related
- Assessing the Positive Predictive Value of International Classification of Diseases Code K55.0 for Identifying Acute Mesenteric Ischaemia
- Catching Two Birds with One Stone: A Primary Open Revascularisation First Approach in a Case Report of Chronic Mesenteric Ischaemia.
- Hybrid management of primary aortic mural thrombus with mesenteric embolization
- Pancreatic Cancer-Associated Pain Management Beyond Opioids: Integrating Oncological Treatment, Palliative Care, and Interventional Pain Medicine
- Prevention and management of bleeding complications in interventional ultrasound: an international expert consensus statement
BibTeX
@article{keady2026endovascular,
title = {{Endovascular management of acute and chronic arterial mesenteric ischaemia: A narrative review of evidence informing interventional radiology treatment}},
author = {Conor Keady and Conor M O’Malley and Sara Azhari Mohamed and Jack Bell and Caroline Crotty and Andrew Patton and Daniel O’Regan and Aoife Keeling and Andrew McGrath and Mark Given and Douglas Mulholland and Mark Sheehan},
journal = {World journal of radiology},
year = {2026},
month = oct,
doi = {10.4329/wjr.125052},
url = {https://europepmc.org/article/PMC/PMC13720588},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Endovascular management of acute and chronic arterial mesenteric ischaemia: A narrative review of evidence informing interventional radiology treatment
AU - Conor Keady
AU - Conor M O’Malley
AU - Sara Azhari Mohamed
AU - Jack Bell
AU - Caroline Crotty
AU - Andrew Patton
AU - Daniel O’Regan
AU - Aoife Keeling
AU - Andrew McGrath
AU - Mark Given
AU - Douglas Mulholland
AU - Mark Sheehan
PY - 2026
DA - 2026/10/28
JO - World journal of radiology
DO - 10.4329/wjr.125052
UR - https://europepmc.org/article/PMC/PMC13720588
AB - Mesenteric ischaemia is a potentially life-threatening vascular disorder caused by impaired intestinal perfusion, with treatment selection requiring consideration of clinical presentation, bowel viability and lesion anatomy. This narrative review examines evidence informing interventional radiology decisions in arterial acute mesenteric ischaemia (AMI) and chronic mesenteric ischaemia (CMI). MEDLINE/PubMed was searched from inception to December 31, 2025, supplemented by reference-list screening and targeted guideline searches. Qualitative evidence synthesis considered patient selection, study design, adjunctive treatments, outcomes and follow-up. In AMI, endovascular techniques can restore perfusion, but predominantly retrospective evidence does not establish superiority over surgery in bowel preservation or survival. For CMI requiring revascularisation, European Society for Vascular Surgery guidelines recommend an initial endovascular approach, supported by Cardiovascular and Interventional Radiological Society of Europe consensus-based guidance. Observational comparisons associate endovascular treatment with lower perioperative morbidity, and surgery with less symptom recurrence. By linking individual treatment decisions to society guidance and supporting studies, this review complements existing comprehensive reviews and guidance documents. It distinguishes formal recommendations and consensus-based practice from technical feasibility and demonstrated comparative patient benefit, while identifying unresolved questions concerning AMI reperfusion strategies and device selection, in addition to antithrombotic therapy and restenosis management in CMI.
SN - 1949-8470
ER -