Endovascular therapy for chronic mesenteric ischemia.
OBJECTIVE
We sought to describe the outcomes of a consecutive series of patients with chronic mesenteric ischemia (CMI) who were treated with percutaneous stent revascularization.


BACKGROUND
Historically, the treatment for CMI has been surgical revascularization. However, surgery carries a significant procedural complication rate and mortality.


METHODS
Fifty-nine consecutive patients with CMI underwent stent placement in 79 stenotic (>70%) mesenteric arteries. All patients had clinical follow-up and 90% had anatomical follow-up with angiography (computed tomography or conventional) or ultrasound at > or =6 months after the procedure.


RESULTS
Procedural success was obtained in 96% (76 of 79 arteries) and symptom relief occurred in 88% (50 patients). At a mean follow-up of 38 +/- 15 months (range, 6 to 112 months), 79% of the patients remained alive, and 17% (n = 10) experienced a recurrence of symptoms. Angiography or ultrasound obtained at 14+/- 5 months after the procedure demonstrated a restenosis rate of 29% (n = 20). All patients with recurrent symptoms had angiographic in-stent restenosis and were successfully revascularized percutaneously.


CONCLUSIONS
Percutaneous stent placement for the treatment of CMI can be performed with a high procedural success and a low complication rate. The long-term freedom from symptoms and vascular patency are comparable with surgical results. The inherent lower procedural morbidity and mortality makes the endovascular approach the preferred revascularization technique for these patients.
Silva
Jose A
JA
Department of Cardiology, Section of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana 70461, USA. jsilva@ochsner.org
White
Christopher J
CJ
Collins
Tyrone J
TJ
Jenkins
J Stephen
JS
Andry
Malcolm E
ME
Reilly
John P
JP
Ramee
Stephen R
SR
D000368:Aged; D017130:Angioplasty; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008643:Mesentery / Q000098:blood supply* / Q000000981:diagnostic imaging; D008875:Middle Aged; D011859:Radiography; D015607:Stents