Endovascular therapy for chronic mesenteric ischemia.
| Autor: | Silva JA; Department of Cardiology, Section of Gastroenterology, Ochsner Clinic Foundation, New Orleans, Louisiana 70461, USA. jsilva@ochsner.org, White CJ, Collins TJ, Jenkins JS, Andry ME, Reilly JP, Ramee SR |
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| Jazyk: | angličtina |
| Zdroj: | Journal of the American College of Cardiology [J Am Coll Cardiol] 2006 Mar 07; Vol. 47 (5), pp. 944-50. Date of Electronic Publication: 2006 Feb 10. |
| DOI: | 10.1016/j.jacc.2005.10.056 |
| Abstrakt: | Objectives: We sought to describe the outcomes of a consecutive series of patients with chronic mesenteric ischemia (CMI) who were treated with percutaneous stent revascularization. Background: Historically, the treatment for CMI has been surgical revascularization. However, surgery carries a significant procedural complication rate and mortality. Methods: Fifty-nine consecutive patients with CMI underwent stent placement in 79 stenotic (>70%) mesenteric arteries. All patients had clinical follow-up and 90% had anatomical follow-up with angiography (computed tomography or conventional) or ultrasound at > or =6 months after the procedure. Results: Procedural success was obtained in 96% (76 of 79 arteries) and symptom relief occurred in 88% (50 patients). At a mean follow-up of 38 +/- 15 months (range, 6 to 112 months), 79% of the patients remained alive, and 17% (n = 10) experienced a recurrence of symptoms. Angiography or ultrasound obtained at 14+/- 5 months after the procedure demonstrated a restenosis rate of 29% (n = 20). All patients with recurrent symptoms had angiographic in-stent restenosis and were successfully revascularized percutaneously. Conclusions: Percutaneous stent placement for the treatment of CMI can be performed with a high procedural success and a low complication rate. The long-term freedom from symptoms and vascular patency are comparable with surgical results. The inherent lower procedural morbidity and mortality makes the endovascular approach the preferred revascularization technique for these patients. |
| Databáze: | MEDLINE |
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