A Narrative Review of Endovascular Approaches for Chronic Mesenteric Ischemia

Chronic mesenteric ischemia typically presents with postprandial abdominal pain and weight loss due to atherosclerotic stenosis of mesenteric arteries. Endovascular treatment has become the first-line management, demonstrating lower early mortality and fewer complications compared to open surgery. Recent evidence shows that covered stents provide superior long-term outcomes, with better primary patency and freedom from reintervention than bare-metal stents. While patient selection remains crucial, with endovascular treatment being preferred for older, higher-risk patients and shorter lesions, it offers shorter hospital stays and comparable survival rates to open surgery for most patients. This review provides a comprehensive overview of current endovascular management strategies for chronic mesenteric ischemia, including patient selection, technical considerations, and outcomes.