1Alaaeldin Ginawi, 1Ganesh Kuhan, 1James Kirk

1University Hospital of Derby and Burton NHS Foundation Trust

Background(s):

Endovascular revascularization (ER) for chronic mesenteric ischemia (CMI) has comparable outcomes with open revascularization, but it is associated with higher rates of restenosis and re-interventions.

Material(s) and Method(s):

All patients treated with ER for CMI between 2012 and 2020 were analysed. Twenty clinical, five anatomical, six procedure-related and seven outcome variables were collected. Kaplan-Meier survival analysis was carried out to identify variables influencing symptom recurrence, re-interventions and survival. Predictors were determined using a log-rank test and Cox regression analysis.

Result(s):

Thirty-seven patients were included with a mean age of 72.9 (range 50-90) years and 64.9% were women. Smokers were 51.4%, 94.6% patients had single-vessel treatment and 81.1% were treated with covered-stent. Median follow up was 59.7 (range 10.7-111.2) months. The 30-day-complications and mortality rates were 16.2% and 5.4% respectively. Symptoms recurred in 18.9% and 10.8% had re-interventions. Median survival was 86.4 (95% CI 29.0-143.8) months, median symptom free survival was 52.9 (95% CI 24.8-81.0) months and median intervention free survival was 86.4 (95% CI 26.4-146.4) months. Smoking was associated with recurrence of symptoms (p=0.028) and re interventions (p=0.033). Revascularisation using covered stents reduced re-interventions (p=0.002).

Conclusion(s):

The use of covered stent and cessation of smoking can improve the outcomes for ER in patients with CMI.