Acute and chronic mesenteric ischaemia (2025 – CME) – online course

Description

Authors: A. M. Ierardi and G. Carrafiello

Reviewers: Z. Aldin, M. Das, A. Gjoreski, T. Kratimenos, J. Nadjiri, L. Raghuram & R. Uberoi.

This course corresponds to chapter 2.2.1.1.8 Visceral arterial disease in the European Curriculum and Syllabus for Interventional Radiology.

Abstract

Mesenteric ischaemia is an acute or chronic perfusion abnormality of the gastrointestinal tract. Acute mesenteric ischaemia (AMI) is a life-threatening vascular emergency with a mortality rate of up to 80%. Chronic mesenteric ischaemia (CMI) is a more insidious disease, which can result in a significant reduction in a patient’s quality of life.

The diagnosis of mesenteric ischaemia is often not apparent due to its non-specific symptoms and signs. However, AMI is an important diagnosis to consider, especially in elderly patients with acute abdominal pain out of proportion to clinical signs, particularly those with a previous history of vascular disease or atrial fibrillation. CMI is a diagnosis of exclusion, but a history of postprandial pain and weight loss is suggestive.

Radiology plays a decisive role in the diagnosis and increasingly in the treatment of mesenteric ischaemia. All clinicians should therefore have a good understanding of what interventional radiology can offer in its treatment.

Imaging modalities are examined and, for each modality, indications are underlined. The gold-standard treatment for mesenteric ischaemia is revascularization of the affected bowel to restore normal perfusion. Traditionally, open surgery was the only treatment option, but patients with mesenteric ischaemia are often elderly with multiple comorbidities and poor nutritional status. In these cases, endovascular treatment represents the first choice.

Learning objectives

• To recognize the presentation of acute and chronic mesenteric ischaemia.
• To characterize mesenteric ischaemia due to vascular causes and coeliac artery compression syndrome.
• To become familiar with the strengths and weaknesses of the various diagnostic tools, to know the techniques for optimal imaging, and to be able to interpret imaging features of mesenteric ischaemia.
• To learn the indications and options for endovascular treatment of mesenteric ischaemia.
• To learn the techniques for endovascular treatment of mesenteric ischaemia.
• To evaluate the immediate and long-term outcomes of interventional procedures.
• To learn and manage the complications of endovascular treatment of mesenteric ischaemia.

Further information

This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 2.2.1.1.8 Visceral arterial disease.

The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one and half hours and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1.5 European CME credit (ECMEC). Please note that this course will be taken offline on January 16, 2030.

The acquired CME Certificate will be available in the myCIRSE area under CIRSE Academy.

The enrolment period of this course is linked to the validity of the All-Access Pass.

Release date: January 2025