Long-term outcome after implementation of endovascular-first strategy to treat acute mesenteric ischemia
Open accessAbstract
Objective To evaluate the rationale of an aggressive endovascular-first strategy to treat elderly patients with acute mesenteric ischemia (AMI) by studying long-term survival, readmissions, and patients' discharge to home vs nursing facility a decade after an episode of AMI. Methods The retrospective study cohort included 66 consecutive patients (all-comers) treated for arterial occlusive AMI between 2009 and 2013. Endovascular revascularization (EVR) was attempted in 50 patients (EVR+), whereas 16 patients were treated without attempted revascularization (EVR-). All patients were followed until death or September 2022. Studied outcomes included discharge status, long-term survival and cause of death and readmissions related to AMI. Results The mean age of all 66 patients was 78 ± 10 years: 79 ± 9 years in the EVR+ group and 76 ± 12 years in the EVR- group. EVR was technically successful in 44 patients (88%); three patients underwent subsequent open revascularization after EVR failure. One-third required bowel resection after EVR. The 30-day mortality for all patients was 44%; 32% in the EVR+ group and 81% in the EVR- group. Only two survivors were permanently institutionalized, whereas all others were discharged to the same place they lived prior to the AMI episode. There were four AMI-related readmissions during the follow-up; all were in the EVR+ group. Two patients underwent reinterventions for recurrent AMI. One-year survival was 52% for EVR+ and 19% for EVR- patients. Five-year survival rates were 18% and 13%, respectively. The causes of deaths were mesenteric ischemia in 22, other cardiovascular event in 21, and non-cardiovascular cause in 19 patients. Four patients were alive at the end of the follow-up. Conclusions In this unselected elderly population with AMI, the aggressive strategy to attempt EVR resulted in a high revascularization rate and favorable outcomes. The high proportion of patients returning to their prior living status and low readmission rate after survival from AMI encourages active treatment of high-functioning elderly patients.
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?
Endovascular revascularisation may offer early survival benefit in AMI, but a comparison with open revascularisation showed equivalent five year survival rates of around 20%.
“Endovascular revascularisation may offer early survival benefit in AMI, but a comparison with open revascularisation showed equivalent five year survival rates of around 20%. 165”
In a small, single centre study with follow up ranging from eight to 13 years, those who survived the initial AMI episode typically died from other cardiovascular diseases.
“In a small, single centre study with follow up ranging from eight to 13 years, those who survived the initial AMI episode typically died from other cardiovascular diseases, which highlights the importance of secondary prevention in these patients. 165”
Re-admissions due to mesenteric ischaemia after surviving the initial episode of AMI are around 8%, and permanent institutionalisation after surviving AMI is also rare, especially in those treated endovascularly.
“Re-admissions due to mesenteric ischaemia after surviving the initial episode of AMI are around 8%, and permanent institutionalisation after surviving AMI is also rare, especially in those treated endovascularly.”
Cites
Arthurs, Z. M., Titus, J., Bannazadeh, M., Eagleton, M. J., Srivastava, S., Sarac, T. P., & Clair, D. G. (2011) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2010.09.049 · Cited by 285 · see citing works
Acute occlusive mesenteric ischemia: surgical management and outcomes
Edwards, M. S., Cherr, G. S., Craven, T. E., Olsen, A. W., Plonk, G. W., Geary, R. L., Ligush, J. L., & Hansen, K. J. (2003) · Annals of Vascular Surgery · doi:10.1007/s10016-001-0329-8 · Cited by 156 · see citing works
Evolution in the Presentation, Treatment, and Outcomes of Patients with Acute Mesenteric Ischemia
Chou, E. L., Wang, L. J., McLellan, R. M., Feldman, Z. M., Latz, C. A., LaMuraglia, G. M., Clouse, W. D., Eagleton, M. J., & Conrad, M. F. (2021) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2021.01.116 · Cited by 51 · see citing works
Najdawi, M., Garzelli, L., Nuzzo, A., Huguet, A., Raynaud, L., Paulatto, L., Panis, Y., Ben Abdallah, I., Castier, Y., Sibert, A., et al. (2022) · European Radiology · doi:10.1007/s00330-022-08660-3 · Cited by 38 · see citing works
Open and endovascular management of acute mesenteric ischaemia: a systematic review
Murphy, B., Dejong, C. H. C., & Winter, D. C. (2019) · World Journal of Surgery · doi:10.1007/s00268-019-05149-x · Cited by 27 · see citing works
Midterm Clinical Outcomes of Retrograde Open Mesenteric Stenting for Mesenteric Ischemia
Cirillo-Penn, N. C., DeMartino, R. R., Rasmussen, T. E., Shuja, F., Colglazier, J. J., Kalra, M., Oderich, G. S., & Mendes, B. C. (2023) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2022.09.062 · Cited by 17 · see citing works
Shi, Y., Su, H., Chen, L., Huang, H., Lu, Z., & Gu, J. (2022) · Journal of Vascular and Interventional Radiology · doi:10.1016/j.jvir.2021.12.008 · Cited by 15 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
Self-citation
- Authors
- Pengermä, P., Venesmaa, S., Karjalainen, J., Ukkonen, M., Saari, P., & Kärkkäinen, J. M.
- Affiliations
- Kuopio University Hospital (FI)
- Corresponding author
- Kärkkäinen, Jussi M.
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 2023-12
- Volume
- 78
- Issue
- 6
- Pages
- 1524-1530
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W4385813326
- Cited by
- 19
- References
- 7
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 4
- FWCI
- 5.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- acute mesenteric ischemia, endovascular revascularization, elderly patients, long-term survival, hospital readmission, discharge disposition, bowel resection
- MeSH terms
- Aged, Aged, 80 and over, Humans, Ischemia, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, 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
