title: Endovascular treatment for chronic atherosclerotic occlusive mesenteric disease: is stenting superior to balloon angioplasty?
abstract: BACKGROUND
  Endovascular treatment is an increasingly used therapeutic option in patients with chronic atherosclerotic occlusive mesenteric disease. Purpose of this study was evaluation of patency and mortality in patients treated with visceral artery percutaneous transluminal angioplasty (PTA) or stenting including follow-up.
  
  
  METHODS
  A retrospective review of 17 consecutive patients (4 women, 13 men) with endovascular treatment for symptomatic chronic mesenteric ischemia from 1998 to 2004 was performed. Mean follow-up period was 42 months. Patient demographics, interventional details, primary and/or secondary patency and mortality were recorded. Cumulative mortality and patency rates were determined using Kaplan-Meier life table analysis.
  
  
  RESULTS
  Twenty-six interventions (PTA alone n=13, PTA and stenting n=13) were performed in 17 patients. Interventions were performed in the superior mesenteric artery (n=13) and celiac artery (n=13). The re-intervention rate was 30% (6/26). Re-interventions were performed for the superior mesenteric artery (n=4) and celiac artery (n=2). Cumulative overall 1-year results were primary patency rate 81%, secondary patency rate 94%, and survival rate 82%. Cumulative 10-year results were primary patency rate 73%, secondary patency rate 94%, and survival rate 65%. The 10-year secondary patency rate was 100% in patients post initial stenting and 86% in patients post initial PTA.
  
  
  CONCLUSIONS
  Long-term follow-up post endovascular treatment for chronic mesenteric ischemia demonstrated a considerable overall secondary patency rate of 94%. However, the long-term secondary patency rate was higher in patients post initial stenting compared to PTA alone.
authors.affiliation: University Hospital Bern, Bern, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Daliri
authors.forename: C
authors.initials: C
authors.lastname: Grunwald
authors.forename: B
authors.initials: B
authors.lastname: Jobst
authors.forename: Z
authors.initials: Z
authors.lastname: Szucs-Farkas
authors.forename: N A
authors.initials: NA
authors.lastname: Diehm
authors.forename: R
authors.initials: R
authors.lastname: Kickuth
authors.forename: D-D
authors.initials: DD
authors.lastname: Do
authors.forename: H
authors.initials: H
authors.lastname: Hoppe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015993:Life Tables; D008297:Male; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency