A comparison of open and endovascular revascularization for chronic mesenteric ischemia in a clinical decision model

Hogendoorn, Wouter; Hunink, M. G. Myriam; Schlösser, Felix J.V.; Moll, Frans L.; Muhs, Bart E.; Sumpio, Bauer E.

doi:10.1016/j.jvs.2014.03.009

Cited by 41 publications

(22 citation statements)

References 31 publications

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“…CONS of asymptomatic patients with popliteal artery aneurysms (0.36 QALYs benefit) 27 and OPEN vs EV in patients with chronic mesenteric ischemia (0.44 QALYs difference). 28 In the decision analysis models, a mean difference of 0.84 QALYs (>10 months in perfect health) is actually a very large difference, given that this is the mean difference for the whole group.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms

Hogendoorn

Lavida

Hunink³

et al. 2015

Journal of Vascular Surgery

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EV is the most cost-effective treatment for most patient groups with SAAs, independent of the sex and risk profile of the patient. EV is superior to OPEN, being both cost-saving and more effective in all age groups. Elderly patients should be considered for CONS, based on the high costs in relation to the very small gain in health when treated with EV. The very elderly should be treated with CONS.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms

Hogendoorn

Lavida

Hunink³

et al. 2015

Journal of Vascular Surgery

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“…However, Zacharias et al [24] recently reported a higher 3-year patency rate using OT (OT 91%; ET 74%), and Arya et al [25] also found higher mid-and long-term patency rates for OT, while Cai et al [26] saw significantly higher symptom recurrence within 3 years with ET. In general, while the reintervention rate appears higher for ET, the method has been considered cost-effective and provides an improvement in quality-adjusted life years [27] . Some authors have suggested ET as first-line treatment, with the caveat that angioplasty should be combined with stenting using covered stents rather than bare-metal stents (based on limited retrospective data), as this approach seems to deliver better freedom from restenosis and symptom recurrence [18,28] .…”

Section: Resultsmentioning

confidence: 99%

Chronic Mesenteric Ischemia: Patient Outcomes Using Open Surgical Revascularization

Wagenhäuser

Meyer-Janiszewski²,

Dueppers³

et al. 2017

Dig Surg

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Background: Chronic mesenteric ischemia (CMI) is a rare disease. Open treatment (OT) remains a valuable treatment option. We analyzed patient outcomes after OT and investigated health-related quality of life (HRQoL). Methods: Data were analyzed retrospectively. The investigation period was from January 1, 2001, to December 31, 2014. We investigated mortality and patency rates using Kaplan-Meier analysis. HRQoL was measured using a 36-item health survey. Various statistical methods were employed. Results: A total of 100 patients (celiac trunk [TC: n = 23], superior mesenteric artery [SMA: n = 26], or both [n = 51]) were included. Median follow-up was 5 ± 35 months. One-year survival rate for TC was 75 ± 11%, for SMA: 79 ± 10%, and for both: 96 ± 3%. TC 5-year survival was 75 ± 11% (SMA: 57 ± 16%: both: 80 ± 8%). Obesity and the length of hospital stay were independently associated with patient survival (p < 0.05). Primary 1-year patency rate was 60 ± 13% for TC (SMA: 86 ± 10%; both: 71 ± 8%) and secondary 1-year patency rate was 84 ± 9% for TC (SMA: 100%; both: 79 ± 7%). HRQoL was inferior compared to the German normative data (p < 0.05). Conclusion: CMI overlaps between gastrointestinal and vascular surgery. OT is safe, and simultaneous revascularization of the TC and the SMA does not affect mortality. Patients would not necessarily benefit from OT in terms of HRQoL.

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“…Furthermore, fewer patients in the endovascular group had bowel resections (14.4% vs 34.4%; P<0.001). A decision analysis model suggested that endovascular intervention is more cost effective for all age groups 11,12 . However, there is currently no Level 1 evidence comparing endovascular treatment with laparotomy.…”

Section: • Thrombolysismentioning

confidence: 99%

Mesenteric ischaemia

Evans¹,

Dovell²,

Smith³

2019

Surgery (Oxford)

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Mesenteric ischaemic is a life--threatening condition that occurs as a result of interrupted or reduced blood flow to the bowel. It is categorised as acute or chronic and encompasses a range of pathology and symptoms. This article looks at the presentation, diagnosis, and management of the following: acute and chronic mesenteric ischaemia, ischaemic colitis, and venous infarction. EPIDEMIOLOGYAcute mesenteric ischaemia (AMI) is a surgical emergency with published mortality rates varying between 50% and 100% 1 . Establishing the incidence of AMI is difficult as it is usually diagnosed intra--operatively, or at autopsy (with varying post--mortem rates). A recent meta-analysis has suggested that the annual incidence of AMI lies between 0.09% and 0.2%, per patient, per year 1 . Median age at presentation is approximately 70 years, and the incidence increases with age, showing no gender difference.

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A comparison of open and endovascular revascularization for chronic mesenteric ischemia in a clinical decision model

Abstract: The results of this decision analysis model suggest that EV is favored over OR for patients with CMI in all age groups. Although EV is associated with more expected reinterventions, EV appears to be cost-effective for all age groups.

Cited by 41 publications

References 31 publications

Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms

Cost-effectiveness of endovascular repair, open repair, and conservative management of splenic artery aneurysms

Chronic Mesenteric Ischemia: Patient Outcomes Using Open Surgical Revascularization

Mesenteric ischaemia

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