Current concepts and evidence on open, endovascular and hybrid treatment of mesenteric ischemia: The retrograde open mesenteric stenting

Abstract

Mesenteric ischemia is still nowadays an underdiagnosed disease with high in-hospital mortality rates. Early diagnosis and intervention are critical in acute mesenteric ischemia. In the past years vascular and general surgeons started to use endovascular and hybrid approaches in order to reduce periprocedural morbidity and mortality. Endovascular and open surgery in asymptomatic patients with chronic mesenterial ischemia (CMI) is usually not indicated. On the other hand, symptomatic CMI should be treated to prevent acute mesenteric ischemia (AMI), bowel infarction and death. It is still controversial in which patients open or endovascular procedures should be performed. Retrograde open mesenteric stenting (ROMS) has been proven to be an alternative to traditional approaches like retrograde and antegrade bypass surgery and could be a potential gold standard when treating acute mesenteric ischemia. Here, we review the contemporary literature of the last 10 years on endovascular, open and hybrid approaches treating acute and chronic mesenteric ischemia.