title: Recanalization of chronic total occlusions of the superior mesenteric artery in patients with chronic mesenteric ischemia: technical and clinical outcomes.
abstract: OBJECTIVE
  To evaluate the safety and outcomes of endovascular recanalization of chronic total occlusions (CTOs) of the superior mesenteric artery (SMA) in patients with chronic mesenteric ischemia (CMI).
  
  
  METHODS
  A single-institution retrospective review was performed of 47 consecutive patients (18 male, 29 female) who underwent endovascular stent placement for CTOs of the SMA between February 2006 and November 2012. All patients had symptoms of CMI. Procedural and follow-up data were collected for assessment of technical success, safety, and outcome.
  
  
  RESULTS
  Technical success was achieved in 41 of 47 patients (87%). Forty-two of the 47 procedures were performed from a femoral approach. Fifteen patients underwent concurrent revascularization of the celiac artery. All patients who underwent successful recanalization reported symptomatic improvement. Kaplan-Meier analysis revealed primary freedom from symptomatic recurrence of 95% at 12 months and 78% at 24 months. Symptomatic recurrence was observed in seven patients, all of whom underwent successful assisted or secondary endovascular procedures. Secondary freedom from symptomatic recurrence rates were 100% at 12 months and 88% 24 months. There were three (7%) minor access-related complications and no major complications.
  
  
  CONCLUSIONS
  Endovascular stent-assisted recanalization of chronic SMA occlusions is safe and effective, with an acceptable rate of technical success and excellent midterm clinical outcomes.
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Grilli
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Fedele
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Osman M
authors.initials: OM
authors.lastname: Tahir
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Clinton W
authors.initials: CW
authors.lastname: Wrigley
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Garcia
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: George
authors.initials: G
authors.lastname: Kimbiris
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718.
authors.forename: Demetrios J
authors.initials: DJ
authors.lastname: Agriantonis
authors.affiliation: Department of Interventional Radiology, Christiana Care Health System, 4755 Ogletown-Stanton Road, Newark, DE 19718. Electronic address: dleung@christianacare.org.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002908:Chronic Disease; D003691:Delaware; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014654:Vascular Patency