Mid-term outcome of endovascular revascularization for chronic mesenteric ischaemia.
BACKGROUND
: This study aimed to assess mid-term outcome after endovascular revascularization of chronic occlusive mesenteric ischaemia (CMI) and to identify possible predictors of mortality.


METHODS
: Consecutive patients undergoing primary elective stenting for CMI between 1995 and 2007 were registered prospectively in a database. Patients with acute ischaemia were excluded. Retrospective case-note review and data analysis were performed.


RESULTS
: Forty-three patients (10 men) were treated for stable (n = 30) or exacerbated (n = 13) CMI. Their median (interquartile range (i.q.r.)) age was 70 (60-79) years. Revascularization was successful in 47 of 49 vessels. The superior mesenteric artery (SMA), either alone (n = 34) or in combination with the coeliac trunk (n = 6), was the predominant target vessel. No patient died within 30 days. Median follow-up was 43 (i.q.r. 25-63) months and the estimated (s.e.) 3-year overall survival rate was 76(7) per cent. Two patients died from distal SMA occlusive disease and intestinal infarction after 6 and 18 months respectively. Previous stroke (P = 0.016), male sex (P = 0.057) and age (P = 0.066) were associated with mid-term mortality on univariable, but not multivariable analysis. Reintervention was needed in 14 patients, achieving a 3-year cumulative rate of freedom from recurrent symptoms of 88(5) per cent.


CONCLUSIONS
: Endovascular treatment provided high early and mid-term survival rates in this series of patients with CMI, with low complication rates.
Dias
N V
NV
Vascular Centre Malmö-Lund, Malmö University Hospital, Malmö, Sweden. nuno.dias@med.lu.se
Acosta
S
S
Resch
T
T
Sonesson
B
B
Alhadad
A
A
Malina
M
M
Ivancev
K
K
D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000601:surgery*; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000401:mortality / Q000601:surgery*; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015607:Stents