View in EDS

Early and Midterm Outcomes of Open and Endovascular Revascularization of Chronic Mesenteric Ischemia

Saved in:
Bibliographic Details
Title: Early and Midterm Outcomes of Open and Endovascular Revascularization of Chronic Mesenteric Ischemia
Authors: Menges, Anna-Leonie, Reutersberg, Benedikt, Busch, Albert, Salvermoser, Michael, Feith, Marcus, Trenner, Matthias, Kallmayer, Michael, Zimmermann, Alexander, Eckstein, Hans-Henning
Contributors: University of Zurich, Eckstein, Hans-Henning
Source: World J Surg
Publisher Information: Wiley, 2020.
Publication Year: 2020
Subject Terms: Male, 2. Zero hunger, Original Scientific Report, Mesenteric Arteries/surgery [MeSH], Angioplasty [MeSH], Female [MeSH], Stents [MeSH], Aged [MeSH], Vascular Surgery, Humans [MeSH], Treatment Outcome [MeSH], Vascular Surgical Procedures/methods [MeSH], Thoracic Surgery, Retrospective Studies [MeSH], General Surgery, Middle Aged [MeSH], Cardiac Surgery, Mesenteric Ischemia/etiology [MeSH], Male [MeSH], Chronic Disease [MeSH], Abdominal Surgery, Vascular Surgical Procedures/adverse effects [MeSH], Surgery, Mesenteric Ischemia/surgery [MeSH], Blood Vessel Prosthesis Implantation [MeSH], Angioplasty, 610 Medicine & health, Middle Aged, 2746 Surgery, ddc, Mesenteric Arteries, 3. Good health, Blood Vessel Prosthesis Implantation, Treatment Outcome, 11548 Clinic for Vascular Surgery, Mesenteric Ischemia, Chronic Disease, Humans, Female, Stents, Vascular Surgical Procedures, Aged, Retrospective Studies
Description: BackgroundRevascularization strategies for chronic mesenteric ischemia (CMI) include open (OR) and endovascular (ER) modalities. The primary objective of this study was to analyze the safety and effectiveness of OR and ER and the impact of clinical and morphological variables on early and midterm outcomes in a consecutive series of CMI patients in a tertiary referral center.Patients and methodsFrom 2004 to 2017, all CMI patients treated with OR and ER were retrospectively identified. Patient records, preoperative imaging, as well as peri‐ and postoperative outcomes were analyzed. Univariable and multivariable analysis was performed to identify clinical or morphological variables affecting reintervention rates within 2 years.ResultsIn total, 63 patients (33% male; mean age 71, range 60–76 years) were treated by ER (41 patients) or OR (22 patients) for CMI. Mean follow‐up was 26 (10–71) months. 30‐day mortality was 0.0% after ER and 4.5% after OR (p = 0.069); 30‐day morbidity was 9.8% vs. 31.8%, respectively (p = 0.030). Length of stay was significantly longer after OR (14 vs. 4 days; p p = 0.14). Overall survival did not differ after 2 years (OR 85% vs. ER 86%; p = 0.35). Multivariable analysis revealed that smoking was associated with higher risk of reintervention (hazard ratio, HR: 4.14; 95% confidence interval, CI 1.11–15.53; p = 0.03). Additionally, a nonsignificant trend of lower reintervention rates after OR was detected (HR 0.23 95% CI 0.05–1.08; p = 0.06).ConclusionDue to a lower invasiveness, despite the higher reintervention rate, an “endovascular first” strategy is justified and recommended.
Document Type: Article
Other literature type
File Description: application/pdf; Publikation_Reutersberg_2020.pdf - application/pdf
Language: English
ISSN: 1432-2323
0364-2313
DOI: 10.1007/s00268-020-05513-2
DOI: 10.5167/uzh-193248
Access URL: https://link.springer.com/content/pdf/10.1007/s00268-020-05513-2.pdf
https://pubmed.ncbi.nlm.nih.gov/32328781
https://www.zora.uzh.ch/id/eprint/193248/
https://www.zora.uzh.ch/id/eprint/193248/1/Publikation_Reutersberg_2020.pdf
https://pubmed.ncbi.nlm.nih.gov/32328781/
https://link.springer.com/content/pdf/10.1007/s00268-020-05513-2.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326829
https://www.ncbi.nlm.nih.gov/pubmed/32328781
https://repository.publisso.de/resource/frl:6470116
https://mediatum.ub.tum.de/1547024
https://www.zora.uzh.ch/id/eprint/193248/
https://doi.org/10.5167/uzh-193248
Rights: CC BY
Accession Number: edsair.doi.dedup.....3cf3b49c939452b4ccb612580c80c1f4
Database: OpenAIRE
Description
Abstract:BackgroundRevascularization strategies for chronic mesenteric ischemia (CMI) include open (OR) and endovascular (ER) modalities. The primary objective of this study was to analyze the safety and effectiveness of OR and ER and the impact of clinical and morphological variables on early and midterm outcomes in a consecutive series of CMI patients in a tertiary referral center.Patients and methodsFrom 2004 to 2017, all CMI patients treated with OR and ER were retrospectively identified. Patient records, preoperative imaging, as well as peri‐ and postoperative outcomes were analyzed. Univariable and multivariable analysis was performed to identify clinical or morphological variables affecting reintervention rates within 2 years.ResultsIn total, 63 patients (33% male; mean age 71, range 60–76 years) were treated by ER (41 patients) or OR (22 patients) for CMI. Mean follow‐up was 26 (10–71) months. 30‐day mortality was 0.0% after ER and 4.5% after OR (p = 0.069); 30‐day morbidity was 9.8% vs. 31.8%, respectively (p = 0.030). Length of stay was significantly longer after OR (14 vs. 4 days; p p = 0.14). Overall survival did not differ after 2 years (OR 85% vs. ER 86%; p = 0.35). Multivariable analysis revealed that smoking was associated with higher risk of reintervention (hazard ratio, HR: 4.14; 95% confidence interval, CI 1.11–15.53; p = 0.03). Additionally, a nonsignificant trend of lower reintervention rates after OR was detected (HR 0.23 95% CI 0.05–1.08; p = 0.06).ConclusionDue to a lower invasiveness, despite the higher reintervention rate, an “endovascular first” strategy is justified and recommended.
ISSN:14322323
03642313
DOI:10.1007/s00268-020-05513-2