title: Endovascular Versus Surgical Revascularization for the Management of Chronic Mesenteric Ischemia.
abstract: BACKGROUND
  Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization (SR) or endovascular revascularization (ER).
  
  
  METHODS
  Systematic review of 12 studies comparing ER and SR in CMI. Primary end point was perioperative (30 days) survival. A secondary composite end point consisted of perioperative mortality, nonfatal cardiac events, nonfatal stroke, and nonfatal bowel ischemia. Further end points included late survival, primary patency, and symptom improvement.
  
  
  RESULTS
  The cumulative odds ratio (OR) for perioperative mortality was 0.78 (95% confidence interval [CI]: 0.40-1.50, P = .45) and 0.56 (95% CI: 0.28-1.11, P = .10) for the composite end point. The cumulative OR for survival after the 30th day was 0.83 (95% CI: 0.47-1.46), P = .51. Late primary patency was reported in 8 studies, with a cumulative OR of 3.57 (95% CI: 1.83-6.97, P = .0002)-favoring SR.
  
  
  CONCLUSIONS
  In the first meta-analysis to compare ER and SR in CMI, there were no differences in mortality and morbidity. Patency rates were better following SR.
authors.affiliation: Division of Metabolic and Vascular Health, University of Warwick, Coventry, United Kingdom West Midlands Vascular Society, West Midlands, United Kingdom.
authors.forename: Mahmud
authors.initials: M
authors.lastname: Saedon
authors.affiliation: West Midlands Vascular Society, West Midlands, United Kingdom Warwickshire Vascular and Endovascular Unit, University Hospital Coventry & Warwickshire, Coventry, United Kingdom a_saratzis@yahoo.gr.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Saratzis
authors.affiliation: West Midlands Vascular Society, West Midlands, United Kingdom Warwickshire Vascular and Endovascular Unit, University Hospital Coventry & Warwickshire, Coventry, United Kingdom.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Karim
authors.affiliation: West Midlands Vascular Society, West Midlands, United Kingdom Warwickshire Vascular and Endovascular Unit, University Hospital Coventry & Warwickshire, Coventry, United Kingdom.
authors.forename: Steve
authors.initials: S
authors.lastname: Goodyear
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: angioplasty; chronic mesenteric ischemia; endovascular; mesenteric angina