Endovascular Recanalisation in Occlusive Mesenteric Ischemia—Feasibility and Early Results
| Autor: | Björn Sonesson, Nuno Dias, Mats Lindh, Petr Uher, Martin Malina, Krassi Ivancev, Timothy Resch |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Colon medicine.medical_treatment Vascular occlusion Asymptomatic Recanalisation Restenosis Superior mesenteric artery medicine.artery Angioplasty Mesenteric Vascular Occlusion medicine Humans Aged Retrospective Studies Medicine(all) Aged 80 and over Endovascular business.industry Stent Middle Aged medicine.disease Mesenteric Arteries Surgery Mesenteric ischemia Stenosis Treatment Outcome Feasibility Studies Female Stents Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 29:199-203 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/j.ejvs.2004.11.004 |
| Popis: | Objective To evaluate a single centre experience of endovascular treatment of mesenteric ischemia caused by vascular occlusion. Design Retrospective study. Material and methods Between 1995 and 2002 17 patients (12 females; mean age 61 years) with symptoms of bowel ischemia were treated endovascularly for arterial occlusion. Vessels were evaluated with angiography and pressure gradient measured. A mean gradient of >20 mmHg or a stenosis of >50% was considered significant. Patient data were recorded prospectively and follow-up was supplemented with retrospective chart review. Fifteen patients had follow up imaging, median 10 months (3–29 months) postoperatively. Median clinical follow up was 14 months (5–42 months). Results Recanalisation was successful in 16 patients (94%). The average number of stents used was 1.6 per patient. For one patient recanalisation failed with subsequent SMA dissection. A celiac artery stenosis was stented but symptoms remained postoperatively. Perioperative mortality was 5.8% ( n =1). 14/17 patients (82%) displayed symptom relief/improvement. Six patients required secondary endovascular intervention; PTA ( n =3); stent/stentgraft ( n =3). Two of these patients required a third procedure. 4/6 patients that underwent secondary intervention were asymptomatic and of recurrent stenosis >75% and a gradient >15 mmHg mean pressure gradient on imaging. Two patients were treated because of a combination of angiographic findings and/or significant pressure gradient combined with clinical symptoms. Conclusions Endovascular treatment of mesenteric ischemia due to vessel occlusion is feasible with acceptable short-term results and limited complications. Most patients experience relief/improvement of symptoms. A significant number of patients might need endovascular re-intervention because of restenosis. |
| Databáze: | OpenAIRE |
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