Comparison of clinical outcomes of endovascular versus open revascularization for chronic mesenteric ischemia: a meta-analysis

Ann Vasc Surg. 2015 Jul;29(5):934-40. doi: 10.1016/j.avsg.2015.01.010. Epub 2015 Mar 7.

Abstract

Background: The purpose of this study is to compare the clinical outcomes of endovascular versus open revascularization for chronic mesenteric ischemia (CMI).

Methods: Published studies that investigated endovascular versus open revascularization for CMI were identified, and meta-analysis was used for statistical analysis.

Results: Eight studies were analyzed by meta-analysis method, cumulative 569 cases were included. Endovascular treatments were performed in 209 cases, and open repairs were performed in 360 cases. Meta-analysis showed that there was no difference in 30-day mortality and 3-year cumulative survival rate between the endovascular group and the open group (P = 0.55 and P = 0.56); compared with the open revascularization group, the endovascular revascularization group resulted in significantly lower rate of in-hospital complication (P = 0.002), while recurrence rate within 3 years after revascularization was significantly greater in the endovascular revascularization group (P < 0.00001).

Conclusion: Endovascular treatment offers a benefit of lower in-hospital complication rate, but a greater recurrence rate within 3 years after revascularization compared with the open revascularization, and both groups have similar 30-day mortality and 3-year cumulative survival rate.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Chi-Square Distribution
  • Chronic Disease
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / mortality
  • Humans
  • Mesenteric Ischemia / diagnosis
  • Mesenteric Ischemia / mortality
  • Mesenteric Ischemia / physiopathology
  • Mesenteric Ischemia / surgery*
  • Mesenteric Vascular Occlusion / diagnosis
  • Mesenteric Vascular Occlusion / mortality
  • Mesenteric Vascular Occlusion / physiopathology
  • Mesenteric Vascular Occlusion / surgery*
  • Odds Ratio
  • Postoperative Complications / etiology
  • Recurrence
  • Risk Factors
  • Splanchnic Circulation
  • Survival Analysis
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects
  • Vascular Surgical Procedures* / mortality