Endovascular versus open revascularization for chronic mesenteric ischemia: a comparative study

Langenbecks Arch Surg. 2008 Nov;393(6):865-70. doi: 10.1007/s00423-008-0355-x. Epub 2008 Jun 25.

Abstract

Background: The aim of our study was to evaluate and compare short- and long-term outcomes of percutaneous angioplasty and open revascularization for chronic intestinal ischemia.

Materials and methods: Twenty-nine consecutive patients undergoing percutaneous angioplasty (n = 14) or open revascularization (n = 15) for chronic intestinal ischemia were prospectively studied from 2000 to 2006. All patients were symptomatic with at least thrombosis or 80% stenosis of superior mesenteric artery.

Results: No patient was lost to follow-up. Patients were older in percutaneous angioplasty than in the open revascularization group (p = 0.0009). Open revascularization allowed to revascularize more vessels (1.4 versus 1, p = 0.01). There was no difference between groups regarding major complications, mortality, hospital length of stay, and symptomatic recurrence. Primary re-stenosis was only observed in three patients (21.4%) in the percutaneous angioplasty group. Survival at 2 years estimated by the Kaplan-Meier method was 58% in the percutaneous angioplasty group and 70% in the open revascularization group (p = NS).

Conclusion: Percutaneous angioplasty should be preferentially offered to older patients and those unable to undergo open revascularization.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon*
  • Blood Vessel Prosthesis Implantation*
  • Chronic Disease
  • Comorbidity
  • Female
  • Hospital Mortality
  • Humans
  • Intestines / blood supply*
  • Ischemia / surgery*
  • Kaplan-Meier Estimate
  • Length of Stay
  • Male
  • Mesenteric Vascular Occlusion / surgery*
  • Middle Aged
  • Pain Measurement
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Secondary Prevention
  • Weight Gain / physiology