Background: Chronic mesenteric ischemia (CMI) is a debilitating gastrointestinal disease process associated with high morbidity and mortality. Percutaneous mesenteric revascularization (percutaneous transluminal angioplasty [PTA] and stenting) has emerged as an alternative treatment option for CMI. The purpose of this study was to evaluate patency rates and outcomes of percutaneous therapy for chronic mesenteric ischemia and define the patient population in whom percutaneous therapy is optimal. Methods: A retrospective analysis was performed on the records of all patients who underwent PTA/Stent for symptomatic chronic mesenteric ischemia between January 2002 and September 2008. Indications for percutaneous mesenteric arterial intervention included postprandial abdominal pain, weight loss and mesenteric arterial stenosis >70%. The endpoint of this study was defined as primary patency. Clinical variables, including patient demographics, co-morbidities and intervention details, potentially associated with the endpoint were collected and analyzed using univariate and multivariate measures, with significance assigned as p<0.05.Results: Forty-eight mesenteric vessels were treated with PTA/Stent in 40 patients. The mean patient age was 70.4 ± 9.7 years (range 43-87 years) with 65%(n=26) female and 35%(n= 14) male. Patient co-morbidities included hypertension (90.0%), coronary artery disease (67.5%), hyperlipidemia (65.0%), diabetes mellitus (35.0%) and smoking history (81.6%). Twenty-one percent (n=10) of the treated vessels required secondary PTA/Stent intervention and 4% (n=2) underwent tertiary percutaneous intervention. There were two perioperative deaths (5%) and four patients (10%) died during follow-up. Mean follow-up was 517 days (range 15-1211 days). Overall primary patency was 89.1% at 1 year and 76.3% at 2 year follow-up. Younger age was associated with a significant lower patency rate, with patients less than 70 years old (n=19) having 1 and 2 year patency rates of 81.8% and 63.6% respectively. Older (>70 years) patients had 1 and 2 year patency rates of 100% (p=0.017).Conclusions: Percutaneous mesenteric intervention represents a feasible option for patients with CMI. However, the overall durability of percutaneous therapy is not as good as published open surgical standards. This study found age as the only correlate of patency in percutaneous intervention for CMI. Due to the decreased long term durability of percutaneous mesenteric intervention in patients less than 70, open surgical revascularization should remain the gold standard for CMI in younger patients, which likely represents a lower risk surgical cohort compared to older patients.