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.
Zerbib
P
P
Service de Chirurgie Digestive et Transplantation, Hôpital Claude Huriez, CHRU de Lille, Lille Cedex, France. p-zerbib@chru-lille.fr
Lebuffe
G
G
Sergent-Baudson
G
G
Chamatan
A
A
Massouille
D
D
Lions
C
C
Chambon
J P
JP
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