Retrograde open mesenteric stenting should be considered as the initial approach to acute mesenteric ischemia
| Autor: | Efthymios D. Avgerinos, Rabih A. Chaer, Lindsey Haga, Michael J. Singh, Michael C. Madigan, Xiaoyi Li, Elizabeth Andraska, Mohammad H. Eslami |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Univariate analysis Surgical approach business.industry Mortality rate education 030204 cardiovascular system & hematology musculoskeletal system Surgery 03 medical and health sciences 0302 clinical medicine Acute mesenteric ischemia medicine In patient 030212 general & internal medicine Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Journal of Vascular Surgery. 72:1260-1268 |
| ISSN: | 0741-5214 |
| DOI: | 10.1016/j.jvs.2020.02.044 |
| Popis: | Objective Retrograde open mesenteric stenting (ROMS) is an alternative to traditional bypass in patients who present with acute mesenteric ischemia (AMI). However, there is a paucity of data comparing outcomes of ROMS with other open surgical approaches. This study represents the largest single-institution experience with ROMS and aims to compare outcomes of ROMS with those of conventional mesenteric bypass. Methods All patients who presented with AMI from 2008 to 2019 and who were treated with either ROMS or mesenteric bypass were included in the study. Patient, procedure, and outcome variables were compared. Bypass and ROMS patients were compared using univariate statistics. Results A total of 34 patients who presented with AMI needing bypass were included in the study; 16 underwent mesenteric bypass, and 18 underwent ROMS. ROMS patients tended to be older than bypass patients and had higher rates of comorbidities. Bypass patients were more likely to have a history of chronic mesenteric symptoms (68.8% vs 27.8%; P = .019). Bypass procedures also took longer than ROMS procedures (302 vs 189 minutes; P Conclusions Complication, reintervention, and mortality rates after ROMS are similar to those of mesenteric bypass in the setting of AMI. Given similar postoperative outcomes and ability to perform these procedures in a conventional operating room but with significantly shorter operative times, ROMS should be considered a first-line option in acute situations when the operator is comfortable performing the procedure. |
| Databáze: | OpenAIRE |
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