title: Endovascular treatment of occluded and stenotic visceral vessels in patients with chronic mesenteric ischemia.
abstract: Objective Current evidence in the literature about endovascular treatment (ET) of visceral vessels in patients with chronic mesenterial ischemia (CMI) based on morphological characteristics is limited. The aim of this study was the evaluation of ET in occluded and stenotic visceral vessels. Methods Patients undergoing ET for CMI between November 2000 and November 2012 were included in this retrospective study. Primary measure outcome was the symptom-free survival (SFS). Secondary outcomes were primary (PPR), secondary patency (SPR) rates and technical success rate (TSR). A Cox-regression analysis identified risk factors for the primary and secondary measure outcomes. Results Forty patients were included in the present study (men: 21, mean age: 68). The overall number of vessels with intention-to-treat was 62. Fifty-two visceral arteries (18 occlusions and 34 stenoses) were successfully treated by endovascular means. The overall TSR was 84%. Visceral vessel occlusions and atherosclerotic disease of the superior mesenteric artery (SMA) were identified as independent risk factors for poorer TSR ( p < 0.05). The 12-month SFS was 60%. The overall 12-month PPR and SPR were 71% and 94%, respectively. No significant differences were observed between occluded and stenotic vessels ( p > 0.05) concerning the PPR. On the other hand, the subgroup analysis revealed higher SPR among occluded visceral vessels ( p < 0.001) and coeliac axis lesions ( p < 0.001). Conclusions ET was associated with high incidence of symptoms recurrence despite the satisfying patency rates in both occluded and stenotic vessels. Additionally, visceral vessel occlusion and presence of atherosclerotic lesions in the SMA were associated with poorer TSR.
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University of Münster, Germany.|2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.
authors.forename: Georgia
authors.initials: G
authors.lastname: Christofi
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University of Münster, Germany.|2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
authors.affiliation: 2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.|3 Division of Vascular Surgery, G. Gennimatas General Hospital, Aristotle University, Thessaloniki, Greece.
authors.forename: Georgios A
authors.initials: GA
authors.lastname: Pitoulias
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University of Münster, Germany.|2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University of Münster, Germany.|2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.
authors.forename: Arne G
authors.initials: AG
authors.lastname: Schwindt
authors.affiliation: 1 Department of Vascular and Endovascular Surgery, University of Münster, Germany.|2 Department of Vascular Surgery, St. Franziskus-Hospital GmbH Münster, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stavroulakis
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002908:Chronic Disease; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: CA; CMI; SMA; occlusions; stenosis