Improved mortality in treatment of patients with endovascular interventions for chronic mesenteric ischemia
Open accessAbstract
Objective Chronic mesenteric ischemia (CMI) continues to be a devastating diagnosis. There is a national trend toward increased use of endovascular procedures with improved survival for the treatment of these patients. Our aim was to evaluate whether this trend has changed CMI patients' length of hospitalization and health care cost. Methods We identified all patients admitted for CMI from the National Inpatient Sample (NIS) from 2000 to 2014. Our primary end points included length of hospital stay (LOS) and cost of hospitalization (COH). Our secondary end points included mortality assessment of the CMI hospitalization. Results There were 15,475 patients admitted for CMI. The mean age of patients was 71 years, and 4022 (26.0%) were male. There were 10,920 (70.6%) patients treated endovascularly (ENDO) and 4555 (29.4%) patients treated in an open fashion (OPEN). Although a higher proportion of patients in the ENDO (43.3%) group vs OPEN (33.1%) had a Charlson Comorbidity Index score of ≥2 (P < .0001), they had a lower mortality rate (2.4% vs 8.7%; P < .0001), lower mean LOS (6.3 vs 14.0 days; P < .0001), and lower COH ($21,686 vs $42,974; P < .0001). After adjusting for clinical and hospital factors, OPEN continued to demonstrate higher mortality than ENDO (odds ratio, 7.2; 95% confidence interval, 4.9-10.6; P < .0001), longer LOS (mean, +9.7 days; P < .0001), and higher COH (mean, +$25,834; P < .0001). Conclusions The rate of ENDO continues to rise nationally in the treatment of CMI patients. After adjusting for clinical and hospital factors, patients in the ENDO group tend to have lower in-hospital mortality of 2.4% and lower LOS by 10 days, and they incur a cost saving of >$25,000 compared with patients in the OPEN group. ENDO should be considered first line of therapy for patients with CMI.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients in the endovascular group, despite a higher comorbidity index, had a lower in hospital mortality rate (2.4% vs. 8.7%) compared with patients in the open approach group.
“A multicentre study including National Inpatient Sample patients treated for CMI showed that patients in the endovascular group, despite a higher comorbidity index, had a lower in hospital mortality rate (2.4% vs. 8.7%) and shorter admission, which incurred a cost saving of more than US$25 000 compared with patients in the open approach group.”
Patients in the endovascular group had shorter admission, which incurred a cost saving of more than US$25,000 compared with patients in the open approach group.
“A multicentre study including National Inpatient Sample patients treated for CMI showed that patients in the endovascular group, despite a higher comorbidity index, had a lower in hospital mortality rate (2.4% vs. 8.7%) and shorter admission, which incurred a cost saving of more than US$25 000 compared with patients in the open approach group.”
During the same period, the volume of open surgery dropped significantly, and revascularisation shifted towards endovascular treatment, especially in comorbid patients.
“During the same period, the volume of open surgery dropped significantly, and revascularisation shifted towards endovascular treatment, especially in comorbid patients.”
Cites
Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases
DEYO, R. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90133-8 · Cited by 10,452 · see citing works
Editor's Choice – Management of the Diseases of Mesenteric Arteries and Veins
Björck, M., Koelemay, M., Acosta, S., Bastos Goncalves, F., Kölbel, T., Kolkman, J. J., Lees, T., Lefevre, J. H., Menyhei, G., Oderich, G., et al. (2017) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2017.01.010 · Cited by 658 · see citing works
Mesenteric revascularization: management and outcomes in the United States, 1988-2006
Schermerhorn, M. L., Giles, K. A., Hamdan, A. D., Wyers, M. C., & Pomposelli, F. B. (2009) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2009.03.004 · Cited by 311 · cited 1× · see citing works
“0001 Median (IQR) 4 (2-8) 9 (6-16) 6 (3-10) <.”
The clinical course of asymptomatic mesenteric arterial stenosis
Thomas, J. H., Blake, K., Pierce, G. E., Hermreck, A. S., & Seigel, E. (1998) · Journal of Vascular Surgery · doi:10.1016/s0741-5214(98)70263-0 · Cited by 231 · see citing works
Atkins, M. D., Kwolek, C. J., LaMuraglia, G. M., Brewster, D. C., Chung, T. K., & Cambria, R. P. (2007) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2007.01.067 · Cited by 217 · see citing works
Current results of open revascularization for chronic mesenteric ischemia: a standard for comparison
Park, W. M., Cherry, K. J., Chua, H. K., Clark, R. C., Jenkins, G., Harmsen, W. S., Noel, A. A., Panneton, J. M., Bower, T. C., Hallett, J. W., et al. (2002) · Journal of Vascular Surgery · doi:10.1067/mva.2002.123753 · Cited by 203 · see citing works
Open versus endovascular revascularization for chronic mesenteric ischemia: Risk-stratified outcomes
Oderich, G. S., Bower, T. C., Sullivan, T. M., Bjarnason, H., Cha, S., & Gloviczki, P. (2009) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2009.02.006 · Cited by 186 · see citing works
ter Steege, R. W. F., & Kolkman, J. J. (2012) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04980.x · Cited by 145 · see citing works
Clinical Course of Mesenteric Artery Stenosis in Elderly Americans
Wilson, D. B., Mostafavi, K., Craven, T. E., Ayerdi, J., Edwards, M. S., & Hansen, K. J. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.19.2095 · Cited by 135 · see citing works
Atherosclerosis of the visceral arteries.
Järvinen, O., Laurikka, J. O., Sisto, T., Salenius, J. ‐., & Tarkka, M. R. (1995) · PubMed · Cited by 109 · see citing works
Intermediate-term outcomes of endovascular treatment for symptomatic chronic mesenteric ischemia
Peck, M. A., Conrad, M. F., Kwolek, C. J., LaMuraglia, G. M., Paruchuri, V., & Cambria, R. P. (2010) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2009.06.064 · Cited by 104 · see citing works
Diagnosis and treatment of chronic mesenteric ischemia: An update
Kolkman, J. J., & Geelkerken, R. H. (2017) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2017.01.003 · Cited by 92 · see citing works
Tallarita, T., Oderich, G. S., Gloviczki, P., Duncan, A. A., Kalra, M., Cha, S., Misra, S., & Bower, T. C. (2013) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2012.09.047 · Cited by 83 · see citing works
Intestinal ischemia: current treatment concepts
Renner, P., Kienle, K., Dahlke, M. H., Heiß, P., Pfister, K., Stroszczynski, C., Piso, P., & Schlitt, H. J. (2010) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-010-0726-y · Cited by 72 · see citing works
Hogendoorn, W., Hunink, M. G. M., Schlösser, F. J. V., Moll, F. L., Muhs, B. E., & Sumpio, B. E. (2014) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2014.03.009 · Cited by 46 · see citing works
Self-citationOutcomes of Endovascular and Open Treatment for Chronic Mesenteric Ischemia
Indes, J., Giacovelli, J. K., Muhs, B. E., Sosa, J. A., & Dardik, A. (2009) · Journal of Endovascular Therapy · doi:10.1583/09-2797.1 · Cited by 46 · see citing works
ACR Appropriateness Criteria ® Radiologic Management of Mesenteric Ischemia
Fidelman, N. A., AbuRahma, A. F., Cash, B. D., Kapoor, B. S., Knuttinen, M. G., Minocha, J., Rochon, P. J., Shaw, C. M., Ray, C. E., & Lorenz, J. M. (2017) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2017.02.014 · Cited by 37 · see citing works
Ryer, E. J., Oderich, G. S., Bower, T. C., Macedo, T. A., Vrtiska, T. J., Duncan, A. A., Kalra, M., & Gloviczki, P. (2011) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2011.01.054 · Cited by 36 · see citing works
Chronic mesenteric ischemia outcome analysis and predictors of endovascular failure
Zacharias, N., Eghbalieh, S. D., Chang, B. B., Kreienberg, P. B., Roddy, S. P., Taggert, J. B., Sternbach, Y., & Darling, R. C. (2016) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2016.02.051 · Cited by 35 · see citing works
Is there a “July effect” for head and neck cancer surgery?
Hennessey, P. T., Francis, H. W., & Gourin, C. G. (2013) · The Laryngoscope · doi:10.1002/lary.23884 · Cited by 27 · see citing works
Veenstra, R. P., ter Steege, R. W. F., Geelkerken, R. H., Huisman, A. B., & Kolkman, J. J. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.09.013 · Cited by 22 · see citing works
Endovascular Therapy for Chronic Mesenteric Ischemia
Foley, T. R., & Rogers, R. K. (2016) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-016-0463-9 · Cited by 16 · see citing works
Sana, A., van Noord, D., Mensink, P., Kooij, S., van Dijk, K., Bravenboer, B., Lieverse, A. G., Sijbrands, E. J. G., Langendonk, J. G., & Kuipers, E. J. (2012) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2012.07.007 · Cited by 12 · see citing works
Chronic mesenteric ischemia: when and how to intervene on patients with celiac/SMA stenosis
Blauw, J. T. M., Bulut, T., Eenhoorn, P., Beuk, R. J., Brusse-Keizer, M. G. J., Kolkman, J. J., & Geelkerken, R. H. (2017) · The Journal of Cardiovascular Surgery · doi:10.23736/s0021-9509.16.09829-3 · Cited by 12 · see citing works
Hospital costs and specialization: benefits of limiting the number of product lines.
Eastaugh, S. R. (2009) · PubMed · Cited by 10 · see citing works
Hospital costs and specialization: benefits of limiting the number of product lines.
Eastaugh (2009) · Journal of health care finance · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery
Huber, T. S., Björck, M., Chandra, A., Clouse, W. D., Dalsing, M. C., Oderich, G. S., Smeds, M. R., & Murad, M. H. (2021) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2020.10.029 · Cited by 152 · see citing works
Koelemay, M. J., Geelkerken, R. H., Kärkkäinen, J., Leone, N., Antoniou, G. A., de Bruin, J. L., Gombert, A., Gottsätter, A., Iborra, E., Ronchey, S., et al. (2025) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2025.06.010 · Cited by 123 · see citing works
Clinical management of chronic mesenteric ischemia
van Dijk, L. J. D., van Noord, D., de Vries, A. C., Kolkman, J. J., Geelkerken, R. H., Verhagen, H. J. M., Moelker, A. D., & Bruno, M. J. (2018) · United European Gastroenterology Journal · doi:10.1177/2050640618817698 · Cited by 82 · see citing works
Early and Midterm Outcomes of Open and Endovascular Revascularization of Chronic Mesenteric Ischemia
Menges, A., Reutersberg, B., Busch, A., Salvermoser, M., Feith, M., Trenner, M., Kallmayer, M. A., Zimmermann, A., & Eckstein, H. (2020) · World Journal of Surgery · doi:10.1007/s00268-020-05513-2 · Cited by 17 · see citing works
Advancements in Treatment Strategies for Chronic Mesenteric Ischemia: A Comprehensive Review
Xhepa, G., Vanzulli, A., Sciacqua, L. V., Inzerillo, A., Faerber, P., Ierardi, A. M., Carrafiello, G., Grande, F. D., & Ricoeur, A. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12227112 · Cited by 16 · see citing works
Prevalence and Impact of Malnutrition in Patients Surgically Treated for Chronic Mesenteric Ischemia
Allain, C., Besch, G., Guelle, N., Rinckenbach, S., & Salomon du Mont, L. (2019) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2019.02.009 · Cited by 13 · see citing works
Patel, R. J., Cui, C., Khan, M. A., Willie-Permor, D., & Malas, M. B. (2023) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2023.02.013 · Cited by 9 · see citing works
Mitchell, E. L. (2020) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2020.11.018 · Cited by 9 · see citing works
Renal and Mesenteric Artery Intervention
Bob‐Manuel, T., & White, C. J. (2020) · Interventional Cardiology Clinics · doi:10.1016/j.iccl.2019.11.002 · Cited by 5 · see citing works
Long-term value in open and endovascular repair of chronic mesenteric ischemia
Lehane, D. J., Geiger, J. T., Kedwai, B. J., Zottola, Z. R., Newhall, K. S., Mix, D., Doyle, A. J., & Stoner, M. C. (2023) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2023.09.003 · Cited by 4 · see citing works
Surgical Intervention for Chronic Mesenteric Ischemia
Klein, A., Bennett, L. F., Ha, C. P., & Kirkwood, M. L. (2018) · Digestive Disease Interventions · doi:10.1055/s-0038-1668539 · Cited by 3 · see citing works
Fassler, M. J., Scali, S. T., Stinson, G. P., Fazzone, B. J., Jacobs, C. R., Jacobs, B. N., Neal, D., Back, M. R., & Huber, T. S. (2025) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2025.08.053 · Cited by 2 · see citing works
How to manage chronic mesenteric ischemia? A deliberated strategy
Damme, H. V., Boesmans, E., Creemers, E., & Defraigne, J.-O. (2019) · Acta chirurgica Belgica · doi:10.1080/00015458.2019.1675971 · Cited by 2 · see citing works
Schmid, B., Gonçalves, V. A., Freire, L. M. D., Nasser, F., & Menezes, F. H. (2024) · Jornal Vascular Brasileiro · doi:10.1590/1677-5449.202301482 · Cited by 1 · see citing works
French Nationwide Outcomes after Revascularisation for Acute and Chronic Mesenteric Ischaemia
Lareyre, F., Chierici, A. P., & Raffort, J. (2026) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2026.05.038 · Cited by 1 · see citing works
Kasprzak, B. (2020) · Gefässchirurgie · doi:10.1007/s00772-019-00599-y · Cited by 1 · see citing works
Symptom relief in patients undergoing endovascular management of chronic mesenteric ischemia
Khalil, O., Waduud, M. A., Bailey, M. A., Hammond, C. J., & Scott, J. H. (2020) · International Angiology · doi:10.23736/s0392-9590.19.04204-4
van Dijk, L. J. D., & Verhagen, H. J. M. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.65687-8
Григорьевна, Ш. А., Lisitsa, A. A., Вячеславович, Д. Д., & Komlev, A. E. (2024) · Экспериментальная и клиническая гастроэнтерология · doi:10.31146/1682-8658-ecg-217-9-75-84
Grewal, S., Kansagra, K., Stone, J. R., & Vatakencherry, G. (2024) · Springer eBooks · doi:10.1007/978-3-031-52546-9_27
Thoracic aorta to inferior mesenteric artery bypass for treatment of chronic mesenteric ischemia
Liggett, M. R., Reilly, M. A., Reddy, N., Lysak, N., Rodríguez, H. E., & Mansukhani, N. A. (2025) · Annals of Vascular Surgery - Brief Reports and Innovations · doi:10.1016/j.avsurg.2025.100360
Suárez, E., Camejo, F., González, S., Fígoli, L., & Diamant, M. (2026) · Journal of Vascular Surgery Cases and Innovative Techniques · doi:10.1016/j.jvscit.2026.102410
Oliveira, N. F. G., Silva, M. J., & Pereirinha, B. (2026) · EJVES Vascular Forum · doi:10.1016/j.ejvsvf.2026.09.001
- Authors
- Erben, Y., Jean, R. A., Protack, C. D., Chiu, A. S., Liu, S., Sumpio, B. J., Miller, S. M., & Sumpio, B. E.
- Affiliations
- Yale University (US)
- Brown University (US)
- Corresponding author
- Erben, Young
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 67
- Issue
- 6
- Pages
- 1805-1812
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W2787059826
- Cited by
- 23
- References
- 26
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 3 · 2020: 6 · 2019: 3 · 2018: 2
- FWCI
- 2.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance (TL1TR001864, TR001864)
- National Institutes of Health (TL1TR001864)
- National Center for Advancing Translational Sciences (TR001864, CTSA Grant No. TL1 TR001864)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Vascular anomalies and interventions
- Keywords
- chronic mesenteric ischemia, endovascular treatment, open surgical revascularization, in-hospital mortality, length of hospital stay, hospital costs, health care costs, treatment trends, National Inpatient Sample, Charlson Comorbidity Index, first-line therapy, mesenteric artery stenosis, acute mesenteric ischemia
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, United States, Stents, Survival Rate, Hospital Mortality, Risk Assessment, Young Adult, Endovascular Procedures, Mesenteric Ischemia
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
