Use of computed tomographic and digital subtraction angiography to determine optimal duplex ultrasound criteria for predicting superior mesenteric artery in-stent restenosis

Over the past two decades, the primary treatment paradigm for chronic mesenteric ischemia (CMI), most frequently caused by superior mesenteric artery (SMA) occlusive disease, has shifted from open surgical towards endovascular therapies. However, endovascular therapies are associated with up to 50% lower primary patency rates largely due to in-stent restenosis (ISR).1 The 2020 Society for Vascular Surgery Clinical Practice Guidelines recommend post-stenting surveillance using duplex ultrasound (DUS).2 However, there are no consensus duplex criteria for SMA ISR.