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      European guidelines on chronic mesenteric ischaemia – joint United European Gastroenterology, European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Gastrointestinal and Abdominal Radiology, Netherlands Association of Hepatogastroenterologists, Hellenic Society of Gastroenterology, Cardiovascular and Interventional Radiological Society of Europe, and Dutch Mesenteric Ischemia Study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia

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          Abstract

          Chronic mesenteric ischaemia is a severe and incapacitating disease, causing complaints of post-prandial pain, fear of eating and weight loss. Even though chronic mesenteric ischaemia may progress to acute mesenteric ischaemia, chronic mesenteric ischaemia remains an underappreciated and undertreated disease entity. Probable explanations are the lack of knowledge and awareness among physicians and the lack of a gold standard diagnostic test. The underappreciation of this disease results in diagnostic delays, underdiagnosis and undertreating of patients with chronic mesenteric ischaemia, potentially resulting in fatal acute mesenteric ischaemia. This guideline provides a comprehensive overview and repository of the current evidence and multidisciplinary expert agreement on pertinent issues regarding diagnosis and treatment, and provides guidance in the multidisciplinary field of chronic mesenteric ischaemia.

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          Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins

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            Median Arcuate Ligament Syndrome-Review of This Rare Disease.

            Median arcuate ligament (MAL) syndrome is a rare disease resulting from compression of the celiac axis by fibrous attachments of the diaphragmatic crura, the median arcuate ligament. Diagnostic workup and therapeutic intervention can be challenging.
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              Duration of dual antiplatelet therapy after drug-eluting stent implantation: a systematic review and meta-analysis of randomized controlled trials.

              The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation is unclear, and its risks and benefits may vary according to DES generation.
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                Author and article information

                Journal
                United European Gastroenterol J
                United European Gastroenterol J
                UEG
                spueg
                United European Gastroenterology Journal
                SAGE Publications (Sage UK: London, England )
                2050-6406
                2050-6414
                16 April 2020
                May 2020
                : 8
                : 4
                : 371-395
                Affiliations
                [1 ]Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
                [2 ]Department of Radiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
                [3 ]Department of Clinical Physiology, Viborg Regional Hospital, Viborg, Denmark
                [4 ]Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
                [5 ]Department of Cardio‐Thoracic and Vascular Surgery, Skane University Hospital, Malmö, Sweden
                [6 ]Department of Vascular Surgery, Sint Antonius hospital, Nieuwegein, the Netherlands
                [7 ]Department of Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
                [8 ]Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
                [9 ]Department of Diagnostic and Interventional Radiology, Montpied University Hospital, Clermont‐Ferrand, France
                [10 ]Department of Gastroenterology, Intestinal Stroke Center, Hopital Beaujon APHP, Clichy, France
                [11 ]Department of Vascular and Endovascular Surgery, Marienhospital Gelsenkirchen, Gelsenkirchen, Germany
                [12 ]Department of Vascular Surgery, Medisch Spectrum Twente, Enschede, the Netherlands
                [13 ]Multi-modality Medical Imaging (M3I) group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, the Netherlands
                [14 ]Department of Surgical Sciences, University of Rome La Sapienza, Rome, Italy
                [15 ]Department of Interventional Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
                [16 ]Heart Center, Kuopio University Hospital, Kuopio, Finland
                [17 ]Department of Vascular Surgery, Mayo Clinic, Rochester, MN, USA
                [18 ]Department of Gastroenterology and Hepatology, Medisch Spectrum Twente, Enschede, the Netherlands
                [19 ]Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands
                [20 ]Department of Radiology, University of Copenhagen, Copenhagen, Denmark
                [21 ]Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Azienda Ospedaliera Universitaria Senese, Siena, Italy
                [22 ]Department of Gastroenterology, Hopital Beaujon APHP, Clichy, France
                [23 ]Department of Surgical Oncological and Oral Sciences, University of Palermo, Vascular Surgery Unit, AOUP ‘P. Giaccone’ Palermo, Palermo, Italy
                [24 ]Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
                [25 ]Department of Vascular Surgery, Erasmus MC University Medical Center, Rotterdam, the Netherlands
                [26 ]Radiology and Nuclear Medicine, University of Basel, Basel, Switzerland
                [27 ]Department of Gastroenterology and Hepatology, Franciscus Gasthuis and Vlietland, Rotterdam, the Netherlands
                Author notes
                [*]Luke G Terlouw, Department of Gastroenterology and Hepatology and Department of Radiology, Erasmus MC University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. Email: l.terlouw@ 123456erasmusmc.nl
                Author information
                https://orcid.org/0000-0002-4983-5741
                https://orcid.org/0000-0002-6507-5666
                https://orcid.org/0000-0003-4640-8725
                https://orcid.org/0000-0002-4707-4563
                Article
                10.1177_2050640620916681
                10.1177/2050640620916681
                7226699
                32297566
                adb77489-0950-4ae3-a7c4-f9a646ed93fe
                © Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 31 January 2020
                : 8 March 2020
                Funding
                Funded by: United European Gastroenterology, FundRef https://doi.org/10.13039/501100012355;
                Award ID: UEG activity grant
                Categories
                Guideline
                Custom metadata
                ts2

                median arcuate ligament syndrome,atherosclerosis,mesenteric arteries,mesenteric artery stenting,coeliac artery release

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