1Alaaeldin Ginawi, 1Ganesh Kuhan, 1James Kirk
1University Hospital of Derby and Burton NHS Foundation Trust
Endovascular revascularization (ER) for chronic mesenteric ischemia (CMI) has comparable outcomes with open revascularization, but it is associated with higher rates of restenosis and re-interventions.
Material(s) and Method(s):
All patients treated with ER for CMI between 2012 and 2020 were analysed. Twenty clinical, five anatomical, six procedure-related and seven outcome variables were collected. Kaplan-Meier survival analysis was carried out to identify variables influencing symptom recurrence, re-interventions and survival. Predictors were determined using a log-rank test and Cox regression analysis.
Thirty-seven patients were included with a mean age of 72.9 (range 50-90) years and 64.9% were women. Smokers were 51.4%, 94.6% patients had single-vessel treatment and 81.1% were treated with covered-stent. Median follow up was 59.7 (range 10.7-111.2) months. The 30-day-complications and mortality rates were 16.2% and 5.4% respectively. Symptoms recurred in 18.9% and 10.8% had re-interventions. Median survival was 86.4 (95% CI 29.0-143.8) months, median symptom free survival was 52.9 (95% CI 24.8-81.0) months and median intervention free survival was 86.4 (95% CI 26.4-146.4) months. Smoking was associated with recurrence of symptoms (p=0.028) and re interventions (p=0.033). Revascularisation using covered stents reduced re-interventions (p=0.002).
The use of covered stent and cessation of smoking can improve the outcomes for ER in patients with CMI.