Surgical and endovascular revascularization of chronic mesenteric ischemia
Open accessAbstract
PURPOSE: Chronic mesenteric ischemia (CMI) is a rare but life-threatening disease. This study reviewed outcomes in patients treated surgically for CMI by open treatment (OT) and endovascular treatment (ET), analyzing risk factors for endovascular failure. METHODS: Clinical data for 36 patients treated for CMI from 2007 to 2017 were retrospectively analyzed. The study's primary endpoint was symptom-free survival. The secondary endpoint was the primary technical success for endovascular and open surgical treatments. Risk factors for endovascular failure were identified by using univariate analysis. RESULTS: Patients were analyzed as treated: 21 patients (58.3%) in the ET and 15 (41.6%) in the OT group. Overall, 20 patients (56%) presented with abdominal angina, 9 (25%) with rest pain, and 7 (19%) without symptoms. An ET was initially attempted in 31 patients (86.1%). The conversion rate from ET to OT was 32.3%, which resulted in a primary technical success of 67.6% in ET and 100% in OT. Six patients from the ET group (19.3%) required surgical revision due to restenosis. One-year (OT 91.6% vs. ET 96.8%; n.s.) and three-year primary patency (OT 91.6% vs. ET 80.6%; n.s.) as well as 3-year symptom-free survival did not differ between the groups (OT 62.5% vs. ET 69.4%; n.s). Overall, in-hospital mortality was 2.8% (n = 1), which was not statistically different between the groups (OT 6% vs. ET 0%; n.s.). High-grade stenosis of the superior mesenteric artery tended to be associated with higher technical failure (P = 0.06). CONCLUSIONS: ET showed a comparable perioperative outcome with higher technical failure. OT was distinguished by excellent early and late technical success.
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Open surgery techniques are associated with higher rates of postoperative major adverse events and 30-day mortality.
“Despite excellent early and late technical success rates associated with open surgery techniques, they have been associated with higher rates of postoperative major adverse events and 30-day mortality [69].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [69]
The Results (Patient outcome; page unavailable) report significantly more major complications after open than endovascular treatment. They report in-hospital mortality, not a 30-day mortality comparison; the higher rate in the open-treatment group (6.7% versus 0%) was not statistically significant (P = 0.42). (LLM, conf=0.87)
Experimental — accuracy not yet measuredOpen surgery techniques have excellent early and late technical success rates.
“Despite excellent early and late technical success rates associated with open surgery techniques, they have been associated with higher rates of postoperative major adverse events and 30-day mortality [69].”
From Revascularization Strategies for Acute and Chronic Mesenteric Ischemia: A Narrative Review (2024) · cites this paper as [69]
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- Authors
- Wolk, S., Kapalla, M., Ludwig, S., Radosa, C., Hoffmann, R.-T., Weitz, J., & Reeps, C.
- Affiliations
- University Hospital Carl Gustav Carus (DE)
- Corresponding author
- Wolk, Steffen
- Venue
- Langenbeck's Archives of Surgery
- Published
- 2022-02-19
- Volume
- 407
- Issue
- 5
- Pages
- 2085-2094
- ISSN
- 0023-8236 (ISSN-L)
- 1435-2451
- PMC
- PMC9399053
- OpenAlex
- W4213009230
- Cited by
- 11
- References
- 28
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 3
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Langenbeck s Archives of Surgery (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by)
- Funders
- Universitätsklinikum Carl Gustav Carus Dresden an der Technischen Universität Dresden
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
- Keywords
- chronic mesenteric ischemia, endovascular revascularization, open surgical revascularization, superior mesenteric artery stenosis, restenosis, primary patency, symptom-free survival, conversion to open surgery, risk factors
- MeSH terms
- Chronic Disease, Constriction, Pathologic, Humans, Ischemia, Mesenteric Vascular Occlusion, Retrospective Studies, Risk Factors, Time Factors, Vascular Patency, Stents, Treatment Outcome, Endovascular Procedures, Mesenteric Ischemia
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