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Cited by 43Abdominal vascular conditions and treatmentsAppendicitis Diagnosis and ManagementIntestinal and Peritoneal Adhesions

Endovascular therapy for acute mesenteric ischemia: an NSQIP analysis

Branco, Bernardino C., Montero-Baker, Miguel F., Aziz, Hassan, Taylor, Zachary, Mills, Joseph L.·2015·The American Surgeon™
DOI 10.1177/000313481508101131
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Abstract

Acute mesenteric ischemia (AMI) continues to carry high morbidity and mortality. Endovascular strategies have been increasingly used in the management of AMI. The purpose of this study was to evaluate the impact of endovascular therapy on outcomes of patients with AMI. The National Surgical Quality Improvement Program database was queried to identify all patients requiring emergency surgical intervention for AMI. Demographics, clinical data, interventions, and outcomes were extracted. Patients were compared according to treatment (endovascular versus hybrid versus open revascularization). Over the six-year study period, a total of 439 patients were found to have AMI [27 (6.2%) endovascular, 23 (5.2%) hybrid, and 389 (88.6%) open revascularization]. A total of 16 (59.3%) patients in the endovascular group avoided laparotomy. There was a trend toward lower transfusion requirements (intraoperative transfusion: 3.7% for endovascular vs 17.4% for hybrid vs 19.3% for open, adjusted. P = 0.127) and complications in particular pneumonia (22.2% vs 39.1% vs 27.8%, respectively, Adj. P = 0.392) and sepsis (25.9% vs 21.7% vs 35.5%, adjusted P = 0.260). Endovascular therapy was associated with a 2.5-fold decrease in the risk of death [odds ratio, 95% confidence interval: 0.4 (0.2, 0.9), adjusted P = 0.018]. In this analysis of morbidity and mortality, endovascular therapy was associated with decreased need for laparotomy and a trend toward lower transfusion requirements and complications, in particular pneumonia and sepsis. Endovascular first therapy was associated with a 2.5-fold decrease in the risk of death. Further prospective evaluation of these results is warranted.

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  • A large registry study from North America pointed to a reduced risk of death and more favourable outcomes in patients selected for endovascular treatment, without establishing any causality between the intervention and outcome.

    “A large registry study29 from North America also pointed to a reduced risk of death and more favourable outcomes in patients selected for endovascular treatment, without establishing any causality between the intervention and outcome.”

    From Acute mesenteric ischaemia (2023) · cites this paper as [29]

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Authors
Branco, B. C., Montero-Baker, M. F., Aziz, H., Taylor, Z., & Mills, J. L.
Affiliations
  • Department of General Surgery, Banner University Medical Center;
  • Tucson Medical Center (US)
  • Southern Arizona VA Health Care System (US)
  • Baylor College of Medicine (US)
Corresponding author
Mills, Joseph L.
ORCID
Venue
The American Surgeon™
Publisher
SAGE Publications
Published
2015-11
Volume
81
Issue
11
Pages
1170-1176
ISSN
  • 0003-1348 (ISSN-L)
  • 1555-9823
DOI
10.1177/000313481508101131
OpenAlex
W2435573252
Cited by
43
References
11
Citations by year
2026: 2 · 2025: 2 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 8
FWCI
3.69
Type
journal article
Language
en
Open access
closed
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • The American Surgeon (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 treatment, hybrid revascularization, open surgical revascularization, laparotomy avoidance, intraoperative blood transfusion, postoperative complications, pneumonia, sepsis, mortality, National Surgical Quality Improvement Program
MeSH terms
Blood Transfusion, Humans, Pneumonia, Postoperative Complications, Databases, Factual, Sepsis, Endovascular Procedures, Mesenteric Ischemia

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