GRADE	Expert agreement
Recommendation 3
To exclude alternative diagnoses at least the following diagnostic tests must be performed: upper gastrointestinal endoscopy and abdominal imaging (CT scan/MRI scan). Depending on age and symptoms colonoscopy should be considered, but is mandatory in patients with diarrhoea.	1D	91%
Recommendation 4
A presumptive diagnosis of occlusive chronic mesenteric ischaemia is based on a combination of compatible history, significant mesenteric artery stenosis on radiological imaging and, preferably, a positive functional test. Results should be discussed in an expert multidisciplinary setting by at least a gastroenterologist, vascular surgeon and (interventional) radiologist.	1C	78%
Recommendation 5
In patients with unexplained abdominal symptoms and significant stenoses of the CA and SMA, the probability of chronic mesenteric ischaemia is high and, consequently, a functional test is not required.	1B	87%
Recommendation 6
For the presumptive diagnosis of chronic mesenteric ischaemia in patients with single-vessel stenosis of CA or SMA, after proper exclusion of alternative diagnoses and no available functional test, the following symptoms should be present: postprandial abdominal pain and either weight loss (>5% body weight) or an adapted eating pattern.	2D	91%
Recommendation 7
(a) A presumptive diagnosis of chronic NOMI is based on a combination of compatible symptoms, absence of significant mesenteric artery stenoses and, preferably, a positive functional test.(b) In presumptive chronic NOMI patients with severe cardiac disease, pulmonary disease or in dialysis patients, underlying causes and treatment should be discussed with the respective specialists.	2D	87%