Reinterventions for stent restenosis in patients treated for atherosclerotic mesenteric artery disease

Tallarita, Tiziano; Oderich, Gustavo S.; Macedo, Thanila A.; Gloviczki, Peter; Misra, Sanjay; Duncan, Audra A.; Kalra, Manju; Bower, Thomas C.

doi:10.1016/j.jvs.2011.06.002

Cited by 87Abdominal vascular conditions and treatmentsPeripheral Artery Disease ManagementRenal and Vascular Pathologies

Reinterventions for stent restenosis in patients treated for atherosclerotic mesenteric artery disease

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Tallarita, Tiziano, Oderich, Gustavo S., Macedo, Thanila A., Gloviczki, Peter, Misra, Sanjay, Duncan, Audra A., Kalra, Manju, Bower, Thomas C.·2011·Journal of Vascular Surgery

DOI 10.1016/j.jvs.2011.06.002

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Abstract

Objective Mesenteric artery angioplasty and stenting (MAS) has been plagued by high restenosis and reintervention rates. The purpose of this study was to review the outcomes of patients treated for mesenteric artery in-stent restenosis (MAISR). Methods The clinical data of 157 patients treated for chronic mesenteric ischemia with MAS of 170 vessels was entered into a prospective database (1998-2010). Fifty-seven patients (36%) developed MAISR after a mean follow-up of 29 months, defined by duplex ultrasound peak systolic velocity >330 cm/s and angiographic stenosis >60%. We reviewed the clinical data, radiologic studies, and outcomes of patients who underwent reintervention for restenosis. End points were mortality and morbidity, patient survival, symptom recurrence, reintervention, and patency rates. Results There were 30 patients (25 female and five male; mean age, 69 ± 14 years) treated with reintervention for MAISR. Twenty-four patients presented with recurrent symptoms (21 chronic, three acute), and six had asymptomatic preocclusive lesions. Twenty-six patients (87%) underwent redo endovascular revascularization (rER) with stent placement in 17 (13 bare metal and four covered) or percutaneous transluminal angioplasty (PTA) in nine. The other four patients (13%) had open bypass, one for acute ischemia. There was one death (3%) in a patient treated with redo stenting for acute mesenteric ischemia. Seven patients (27%) treated by rER developed complications, including access site problems in four patients, and distal embolization with bowel ischemia, congestive heart failure and stent thrombosis in one each. Symptom improvement was noted in 22 of the 24 symptomatic patients (92%). After a mean follow-up of 29 ± 12 months, 15 patients (50%) developed a second restenosis, and seven (23%) required other reintervention. Rates of symptom recurrence, restenosis, and reinterventions were 0/4, 0/4, and 0/4 for covered stents, 2/9, 3/9, and 2/9 for PTA, 5/13, 8/13, and 5/13 for bare metal stents, and 1/4, 4/4, and 0/4 for open bypass. For all patients, freedom from recurrent symptoms, restenosis, and reinterventions were 70% ± 10%, 60% ± 10% and 50% ±10% at 2 years. For patients treated by rER, secondary patency rates were 72 ± 12 at the same interval. Conclusions Nearly 40% of patients developed mesenteric artery in-stent restenosis, of which half required reintervention because of symptom recurrence or progression to an asymptomatic preocclusive lesion. Mesenteric reinterventions were associated with low mortality (3%), high complication rate (27%), and excellent symptom improvement (92%).

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Re-interventions were associated with a low mortality rate (3%), high risk of complications (27%), and excellent symptom improvement (92%).
“Re-interventions were associated with a low mortality rate (3%), high risk of complications (27%), and excellent symptom improvement (92%).”
From Editor's Choice - European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. (2025) · cites this paper as [57]
Several studies reported acceptable technical success of endovascular re-intervention after both primary endovascular and open revascularisation.
“Several studies reported acceptable technical success of endovascular re-intervention after both primary endovascular and open revascularisation.”
From Editor's Choice - European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Diseases of the Mesenteric and Renal Arteries and Veins. (2025) · cites this paper as [57]

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Self-citation

Authors: Tallarita, T., Oderich, G. S., Macedo, T. A., Gloviczki, P., Misra, S., Duncan, A. A., Kalra, M., & Bower, T. C.
Affiliations: Mayo Clinic (US)
Corresponding author: Oderich, Gustavo S.
ORCID: Tallarita, Tiziano
Oderich, Gustavo S.
Macedo, Thanila A.
Misra, Sanjay
Duncan, Audra A.
Kalra, Manju
Venue: Journal of Vascular Surgery
Publisher: Elsevier BV
Published: 2011-11
Volume: 54
Issue: 5
Pages: 1422-1429.e1
ISSN: 0741-5214 (ISSN-L)
DOI: 10.1016/j.jvs.2011.06.002
OpenAlex: W2020301331
Cited by: 87
References: 27
Citations by year: 2026: 2 · 2025: 8 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 10 · 2018: 5 · 2017: 7 · 2016: 4 · 2015: 9 · 2014: 7 · 2013: 9 · 2012: 5
FWCI: 6.83
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 731 d)
Locations: Journal of Vascular Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
Keywords: chronic mesenteric ischemia, acute mesenteric ischemia, reintervention, percutaneous transluminal angioplasty, covered stent, bare-metal stents, stent thrombosis, distal embolization, stent patency
MeSH terms: Aged, Aged, 80 and over, Constriction, Pathologic, Female, Humans, Male, Mesenteric Arteries, Mesenteric Vascular Occlusion, Middle Aged, Minnesota, Prosthesis Design, Recurrence, Retrospective Studies, Risk Factors, Time Factors, Tomography, X-Ray Computed, Vascular Patency, Stents, Survival Rate, Chi-Square Distribution, Treatment Outcome, Angioplasty, Risk Assessment, Ultrasonography, Doppler, Duplex, Retreatment, Atherosclerosis, Kaplan-Meier Estimate

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Reinterventions for stent restenosis in patients treated for atherosclerotic mesenteric artery disease

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