Management and outcomes of chronic mesenteric ischemia in older adults: A comprehensive review

Chronic mesenteric ischemia (CMI) is a rare, yet increasingly prevalent, condition, especially among older adults. Diagnosing CMI in older adults presents significant challenges. Along with the burden of comorbidities and the physiological changes associated with aging, timely intervention is often delayed, leading to poorer outcomes. Current diagnostic protocols and treatment guidelines do not address the unique challenges faced by this population. In this comprehensive review, the authors examined the existing literature on diagnostic strategies and management options for CMI in older adults. The importance of a thorough preoperative workup and early optimization to minimize perioperative stress, while considering nutritional and functional capabilities, is emphasized. Risk stratification models incorporating frailty and other geriatric-specific indices can inform therapeutic decisions and improve outcomes. Despite the increasing disease burden in this group, there are limited data on long-term outcomes, the impact of nutrition, and quality of life metrics after intervention. This emphasizes the necessity for more prospective studies to address these gaps and implement age-specific approaches for the evaluation and treatment of older adult patients with CMI.