Nagatomi Satoru, Kanamori Daigo, Yamamoto Hiroshi
Department of Radiology, Sumitomo Hospital, Japan.
Interv Radiol (Higashimatsuyama). 2025 Aug 1;10:e20240057. doi: 10.22575/interventionalradiology.2024-0057. eCollection 2025.
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.
慢性肠系膜缺血通常表现为餐后腹痛和体重减轻，这是由于肠系膜动脉粥样硬化狭窄所致。血管内治疗已成为一线治疗方法，与开放手术相比，其早期死亡率更低，并发症更少。最近的证据表明，覆膜支架能提供更好的长期疗效，与裸金属支架相比，其初始通畅率更高，再次干预的可能性更小。虽然患者选择仍然至关重要，对于年龄较大、风险较高的患者以及较短病变，血管内治疗更为可取，但对于大多数患者而言，它能缩短住院时间，且生存率与开放手术相当。本综述全面概述了慢性肠系膜缺血目前的血管内治疗策略，包括患者选择、技术考量和治疗结果。
