Surgical and Interventional Visceral Revascularization for the Treatment of Chronic Mesenteric Ischemia—When to Prefer Which?

Biebl, Matthias; Oldenburg, W. Andrew; Paz‐Fumagalli, Ricardo; McKinney, J. Mark; Hakaim, Albert G.

doi:10.1007/s00268-006-0434-5

Cited by 74 publications

(41 citation statements)

References 38 publications

(75 reference statements)

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“…Atkins et al reported in a cohort of 80 patients with CSS primary patency at 1 year of 58% after endovascular and 90% after open repair and a primary assisted patency of 65% vs 96% respectively [95] . Bieble et al reported that in a cohort of 49 patients with CSS, 75% after endovascular and 89% after open repair were symptom free after 2 years [96] . The main difference in this study was the restenosis rate of 8% after open versus 25% after endovascular treated patients, with lower complication rates in the latter.…”

Section: Work-up and Treatmentmentioning

confidence: 99%

Diagnosis and management of splanchnic ischemia

Kolkman¹,

Bargeman²,

Huisman³

et al. 2008

WJG

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Section: Work-up and Treatmentmentioning

confidence: 99%

Diagnosis and management of splanchnic ischemia

Kolkman¹,

Bargeman²,

Huisman³

et al. 2008

WJG

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“…He concluded that for patients with low surgical risk, OR could be considered the first line treatment. Biebl et al [13] conducted a retrospective analysis comparing 26 patients undergoing OR to 23 patients undergoing PTA, among which 96% had stenting. The re-stenosis rate was significantly higher in the PTA cohort.…”

Section: Discussionmentioning

confidence: 99%

Endovascular versus open revascularization for chronic mesenteric ischemia: a comparative study

Zerbib

Lebuffe

Sergent-Baudson

et al. 2008

Langenbecks Arch Surg

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“…5 Surgical treatment has superior long-term patency and requires fewer reinterventions, but it is also more invasive with greater morbidity and mortality compared to endovascular treatment. 8 Patients older than 70 y with other comorbidities and poor nutritional status had increased operative mortality and decreased survival rates. Endovascular therapy is appropriate for this subset of patients.…”

Section: Discussionmentioning

confidence: 99%

“…8 In Kasirajan et al, 28 patients underwent PTA and when a comparison was made to 85 patients with OS they found that 3 years cumulative recurrent stenosis and mortality rate did not differ. 9 Patients with recurrent symptoms had angiographic in-stent restenosis and were successfully revascularized percutaneously.…”

Section: )mentioning

confidence: 97%

Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly Patients

Penugonda

Gardi

Schreiber

2009

Clinical Cardiology

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This review article focuses on stent placement in mesenteric arteries in older patients with an increasingly common diagnosis of chronic mesenteric ischemia (CMI). We reviewed the articles that focused on the treatment of this gastrointestinal disorder by stenting/open surgical revascularization to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in mesenteric arteries are discussed in comparison to open surgical revascularization. In summary, the low morbidity and high technical success rate of catheter-based techniques have made this approach the first line of therapy for CMI due to superior mesenteric artery stenosis for many elderly patients especially high-risk operative candidates. BackgroundClinical manifestations of chronic mesenteric ischemia (CMI) can range from vague abdominal pain to debilitating states of intestinal angina resulting in significant weight loss and morbidity. CMI due to atherosclerotic occlusive disease was first reported in 1936 and is a relatively uncommon disorder. This entity usually occurs in patients over 60 y of age with other atherosclerotic symptoms. The rise in an aging population in the coming years could result in an increasing prevalence of chronic mesenteric ischemia. 1 Once the condition has been diagnosed, treatment is usually elective, except in rare cases of rapid progression to acute mesenteric ischemia. Medical management of CMI is mostly supportive. 2 If CMI is diagnosed, there are two therapeutic options: (1) surgical revascularization of 1 of the stenosed or occluded mesenteric arteries or (2) radiological intervention employing percutaneous transluminal angioplasty (PTA) with or without stent placement of 1 or more mesenteric arteries. The success of surgery or radiological intervention is determined by the relief of symptoms and the durability of such relief. 3 Traditional treatment consists of open surgical (OS) revascularization. Despite significant perioperative morbidity and mortality rates, OS revascularization has traditionally been the treatment of choice. The most frequent indications include pain relief, improvement of nutritional status, and prevention of intestinal infarction. Endovascular therapy seems to be a valid alternative, mainly in high-risk patients, with good immediate and medium-term results.

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Surgical and Interventional Visceral Revascularization for the Treatment of Chronic Mesenteric Ischemia—When to Prefer Which?

Cited by 74 publications

References 38 publications

Diagnosis and management of splanchnic ischemia

Diagnosis and management of splanchnic ischemia

Endovascular versus open revascularization for chronic mesenteric ischemia: a comparative study

Percutaneous Intervention of Superior Mesenteric Artery Stenosis in Elderly Patients

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