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Home Radiologic Management of Mesenteric Ischemia

Variants

Recent onset abdominal pain, no peritoneal signs, and known atrial fibrillation. CTA shows calcified atherosclerotic plaque involving the aorta and its major branches, as well as proximal short-segment occlusion of the proximal SMA. No intramural or extra-luminal air. Initial therapy.

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Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Recent onset abdominal pain, no peritoneal signs, and known atrial fibrillation. CTA shows calcified atherosclerotic plaque involving the aorta and its major branches, as well as proximal short-segment occlusion of the proximal SMA. No intramural or extra-luminal air. Initial therapy.

3195691

Angiography and endovascular intervention including possible thrombolysis, angioplasty, or stent placement

Usually appropriate

Systemic anticoagulation

Usually appropriate

Surgical endarterectomy or bypass

May be appropriate