Open Mesenteric Interventions Are Equally Safe as Endovascular Interventions and Offer Better Midterm Patency for Chronic Mesenteric Ischemia

Shipra Arya, Stephanie Kingman, Jordan P. Knepper, Jonathan L. Eliason, Peter K. Henke, John E. Rectenwald

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background Endovascular (EV) techniques are being advocated as the preferred method for mesenteric interventions because of their safety profile. However, midterm and long-term results are thought to be inferior to open interventions. We sought to compare our institutional experience with treatment of acute and chronic mesenteric ischemia (AMI and CMI, respectively) using EV and open techniques. Methods The medical records of open and EV mesenteric procedures performed at a single center were queried from 2002 to 2012. Demographic, perioperative, and follow-up data were extracted and analyzed. Results Thirty-eight patients underwent EV mesenteric interventions, whereas 77 patients underwent open revascularization. The demographic and perioperative characteristics for patients were similar. Most EV procedures (89.2%) comprised stenting, whereas open procedures included 25 (32.1%) antegrade bypasses, 38 (48.7%) retrograde bypasses, 8 (10.3%) thromboembolectomies, and 7 (9%) transaortic endarterectomies. Postoperative complications, overall 30-day morbidity and mortality were not significantly different in the open and EV groups for AMI or CMI. Thirty-day mortality in AMI (n = 34) was 38.2% (EV: 45.5% vs. open: 34.8%; P = nonsignificant). There was no mortality in either group for CMI patients. Mean follow-up was much longer for the open procedures (34.9 vs. 12.7 months, P = 0.004). Primary and secondary patency rates were better for open revascularization for CMI patients. Conclusions Open revascularizations are equally safe as EV interventions for AMI and CMI. Patency of open revascularization for CMI is better than EV procedures at midterm follow-up.

Original languageEnglish (US)
Pages (from-to)219-226
Number of pages8
JournalAnnals of Vascular Surgery
Volume30
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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