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Endovascular Revascularization as Primary Treatment for Acute Embolic Mesenteric Ischemia: Stent Thrombectomy plus Aspiration versus Aspiration Alone
Institution:Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing 210006, China
Abstract:PurposeTo investigate the outcomes of stent thrombectomy combined with aspiration versus aspiration alone in acute mesenteric ischemia (AMI).Materials and MethodsThis was a single-center, retrospective cohort study. Between May 1, 2012, and January 1, 2021, 41 patients (mean age, 73.8 years ± 7.9) with AMI who underwent stent thrombectomy plus aspiration (Group 1, n = 14) or aspiration alone (Group 2, n = 27) were included. The treatment regimens and clinical and follow-up outcomes of the patients were reviewed and analyzed. Group differences were compared using a χ2 test, Fisher exact test, independent t test, or Mann-Whitney U test. The cumulative survival rate was calculated using a Kaplan-Meier curve.ResultsThe overall clinical success rate was 78.0% (32/41), and no significant differences were found between Group 1 and Group 2 (78.6% vs 77.8%, P = 1.00). Compared with Group 2, Group 1 was associated with a higher complete clearance rate (44.4% vs 78.6%, P = .04), less adjunctive local thrombolysis (48.1% vs 14.3%, P = .03), and a shorter length of hospital stay (10.7 days ± 9.0 vs 5.7 days ± 4.7, P = .03). The estimated survival rates at 1 month, 3 months, 6 months, 1 year, and 2 years were 73.2%, 72.5%, 71.4%, 65.3%, and 59.8%, respectively. No significant difference was found in the survival rate between the groups (log-rank test, P = .96). The recurrence rates for Group 1 and Group 2 were 8.3% (1/12) and 4.0% (1/25), respectively.ConclusionsCompared with aspiration alone, aspiration combined with stent thrombectomy showed a higher complete clearance rate, reduced adjunctive thrombolysis, and a shorter length of hospital stay.
Keywords:AMI"}  {"#name":"keyword"  "$":{"id":"kwrd0015"}  "$$":[{"#name":"text"  "_":"acute mesenteric ischemia  EVR"}  {"#name":"keyword"  "$":{"id":"kwrd0025"}  "$$":[{"#name":"text"  "_":"endovascular revascularization  SMA"}  {"#name":"keyword"  "$":{"id":"kwrd0035"}  "$$":[{"#name":"text"  "_":"superior mesenteric artery
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