Endovascular versus open revascularization for chronic mesenteric ischemia: a comparative study.
BACKGROUND
The aim of our study was to evaluate and compare short- and long-term outcomes of percutaneous angioplasty and open revascularization for chronic intestinal ischemia.


METHODS
Twenty-nine consecutive patients undergoing percutaneous angioplasty (n = 14) or open revascularization (n = 15) for chronic intestinal ischemia were prospectively studied from 2000 to 2006. All patients were symptomatic with at least thrombosis or 80% stenosis of superior mesenteric artery.


RESULTS
No patient was lost to follow-up. Patients were older in percutaneous angioplasty than in the open revascularization group (p = 0.0009). Open revascularization allowed to revascularize more vessels (1.4 versus 1, p = 0.01). There was no difference between groups regarding major complications, mortality, hospital length of stay, and symptomatic recurrence. Primary re-stenosis was only observed in three patients (21.4%) in the percutaneous angioplasty group. Survival at 2 years estimated by the Kaplan-Meier method was 58% in the percutaneous angioplasty group and 70% in the open revascularization group (p = NS).


CONCLUSIONS
Percutaneous angioplasty should be preferentially offered to older patients and those unable to undergo open revascularization.
Service de Chirurgie Digestive et Transplantation, Hôpital Claude Huriez, CHRU de Lille, Lille Cedex, France. p-zerbib@chru-lille.fr
P
P
Zerbib
G
G
Lebuffe
G
G
Sergent-Baudson
A
A
Chamatan
D
D
Massouille
C
C
Lions
J P
JP
Chambon
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D019917:Blood Vessel Prosthesis Implantation; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D015430:Weight Gain / Q000502:physiology