Background Mesenteric ischemia is associated with poor outcome and high overall mortality. The aim was to analyze an interdisciplinary treatment approach of vascular and visceral specialists focusing on the in-hospital outcome and follow-up in patients with acute and acute-on-chronic mesenteric ischemia. Methods From 2010 until 2017, 26 consecutive patients were treated by an interdisciplinary team. Data were prospectively collected and retrospectively evaluated. Throughout the initial

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... on, the extent of bowel resection was determined by the visceral and the appropriate mode of revascularization by the vascular surgeon. The routine follow-up included ultrasound- or CT-imaging. Results Out of 26 patients, 18 (69.2%) were rendered for open repair. Ten patients received reconstruction of the superior mesenteric artery with an iliac-mesenteric bypass. Seven patients (26.9%) underwent thrombembolectomy of the mesenteric artery. One patient received an infra-diaphragmatic aorto-celiac-mesenteric bypass. Out of the 8 patients, who were not suitable for open revascularisation, 2 patients (7.7%) were treated endovascularly and 6 (23.1%) underwent explorative laparotomy. The in-hospital mortality was 23% (n=6). The mean survival of the revascularized group (n=20) was 51.8 months (95% CI 39.1-64.5) compared to 15.7 months in the non-revascularized group (n=6) (95% CI -4.8-36.1; p=0.08). The median follow-up was 64.6 months. Primary patency in the 16 patients after open and 2 after interventional revascularisation was 100% and 89.9% in the follow-up. Conclusion The interdisciplinary treatment of mesenteric ischemia improves survival if carried out in time. Hereby open revascularization measures are advantageous as they allow bowel assessment, resection, and revascularization in a one-stop fashion especially in advanced cases.