Acute and chronic mesenteric ischaemia (CME) – online course
Authors: A. M. Ierardi and G. Carrafiello
Reviewers: L. Kamper, H. van Overhagen, T. Jahnke, R. Uberoi and C. Nice
This course corresponds to chapter 18.104.22.168.8 Visceral Arterial Disease in the European Curriculum and Syllabus for IR.
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 patient quality of life.
The diagnosis of Mesenteric Ischaemia is often not immediate 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 revascularisation 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.
- To recognise the presentation of acute and chronic mesenteric ischaemia
- To characterise mesenteric ischaemia due to vascular causes and celiac 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
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 22.214.171.124.8 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 hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on January 23, 2022. A non-CME accredited version of the course will remain available until the new CME accredited course is published.
Upon purchase, access to complete and revisit the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before January 23, 2022.
Release date: January 2020