Comment on "the role of endoscopic ultrasound in the evaluation of chronic mesenteric ischaemia"

We read with great interest the article by Almansa et al. published in Digestive and Liver Disease regarding the role of Doppler endoscopic ultrasound as a comprehensive test to evaluate patients with chronic upper abdominal pain in order to exclude chronic mesenteric ischaemia [1]. In this study, authors employed, both in Doppler endoscopic ultrasound and Dopper transabdominal ultrasound, measurement of Peak Systolic Velocity (PSV) in celiac artery and superior mesenteric artery as single parameter for the detection of chronic mesenteric ischaemia. We would add that, beside PSV, another Doppler parameter could be considered: End-Diastolic Velocity (EDV) appears comparable or superior to PSV in identify significant arteriography-detected stenosis, and is not influenced by an hyperdynamic circulation as for PSV [2], [3], [4] and [5]. In the study of Almansa et al., Doppler endoscopic ultrasound (assessed by means of PSV) presented a specificity of 84% in detecting chronic mesenteric ischaemia; this figure could be even more appealing employing EDV.