title: Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease.
abstract: OBJECTIVE
  To compare outcomes of mesenteric angioplasty and stenting using iCAST covered stents (CS; Atrium, Hudson, NH) or bare metal stents (BMS) in patients with chronic mesenteric ischemia (CMI).
  
  
  METHODS
  We reviewed the clinical data of 225 patients (65 male and 160 female; mean age, 72 ± 12 years) treated for CMI at two academic centers (2000-2010). Outcomes were analyzed in patients who had primary intervention or reintervention using BMS (n = 164 patients/197 vessels) or CS (n = 61 patients/67 vessels). End points were freedom from restenosis, symptom recurrence, reinterventions, and patency rates.
  
  
  RESULTS
  Patients in both groups had similar demographics, cardiovascular risk factors, and extent of disease. In the primary intervention group (mean follow-up, 29 ± 12 months), patients treated by CS had higher freedom from restenosis (92% ± 6% vs 53% ± 4%; P = .003), symptom recurrence (92 ± 4% vs 50 ± 5%; P = .003), reintervention (91% ± 6% vs 56% ± 5%; P = .005), and better primary patency at 3 years (92% ± 6% vs 52% ± 5%; P < .003) than for BMS. In the reintervention group (mean follow-up, 24 ± 9 months), patients treated by CS had higher freedom from restenosis (89% ± 10% vs 49% ± 14%; P < .04), symptom recurrence (100% vs 64%± 9%; P = .001), and reintervention (100% vs 72% ± 9%; P = .03) at 1 year, and a trend toward improved primary patency at 1 year (100% vs 63% ± 9%; P = .054). Secondary patency rates were similar in both groups.
  
  
  CONCLUSIONS
  In this nonrandomized study, CS were associated with less restenosis, recurrences, and reinterventions than BMS in patients undergoing primary interventions or reinterventions for CMI.
authors.affiliation: Division of Vascular and Endovascular Surgery and Department of Epidemiology, Mayo Clinic, Rochester, Minn. Electronic address: oderich.gustavo@mayo.edu.
authors.forename: Gustavo S
authors.initials: GS
authors.lastname: Oderich
authors.forename: Luke S
authors.initials: LS
authors.lastname: Erdoes
authors.forename: Christopher
authors.initials: C
authors.lastname: Lesar
authors.forename: Bernardo C
authors.initials: BC
authors.lastname: Mendes
authors.forename: Peter
authors.initials: P
authors.lastname: Gloviczki
authors.forename: Stephen
authors.initials: S
authors.lastname: Cha
authors.forename: Audra A
authors.initials: AA
authors.lastname: Duncan
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Bower
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation*; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008638:Mesenteric Arteries / Q000503:physiopathology; D065666:Mesenteric Ischemia; D008670:Metals; D008875:Middle Aged; D008910:Minnesota; D015999:Multivariate Analysis; D016017:Odds Ratio; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013714:Tennessee; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014654:Vascular Patency
chemical_list: D008670:Metals