The main goal in the treatment of CMI is to restore the mesenteric blood flow. Most patient, regardless of the extent of the disease, require some form of surgical intervention and arterial reconstruction. Before this can be carried out nutritional repletion may be necessary, which may include partial parental nutrient. Selecting the right procedure depends on the distribution of the disease, the presence of associated arterial lesions, and the severity of associated systemic illness. Balloon angioplasty has been used on patients, but early recurrence of stenosis has been frequent in the visceral arteries.
Aortovisceral bypass remains a popular option for many vascular surgeons.
Prosthetics conduits are ideal for this procedure. Prosthetics grafts are often used instead of a vein graft due to the greater chance of a vein graft kinking onto its self. These prosthetic grafts which are usually made of crimped woven Dacron can be oriented in a retrograde fashion by attaching there proximal ends to the infrarenal aorta and the distal end to the visceral vessel. Transaortic visceral endarterectomy was the original procedure used to relieve symptomatic obstruction of the superior mesenteric artery. It was first done in a retrograde manner from the superior mesenteric artery in the aorta.