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Recanalization of Chronic Total Occlusions of the Superior Mesenteric Artery in Patients with Chronic Mesenteric Ischemia: Technical and Clinical Outcomes |
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| Institution: | 1. Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;2. Division of Molecular Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;3. Division of Hematology/Oncology, Center for Liver Cancer, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, 290 Gray/Bigelow, Boston, MA 02114.;1. Department of Radiology, Montefiore Medical Center-Weiler Division, 1825 Eastchester Road, Bronx, NY 10461;2. Department of Radiology, North Shore University Hospital, Manhasset, New York;3. Department of Radiology, New York Medical College, Westmed Medical Group, White Plains, New York;1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;2. Department of Gastroenterological Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;3. Department of General Thoracic Surgery, Okayama University Medical School, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan;1. Department of Interventional Radiology, St. Antonius Hospital, Koekoekslaan 1, CM Nieuwegein 3435, The Netherlands;2. Department of Vascular Surgery, St. Antonius Hospital, Koekoekslaan 1, CM Nieuwegein 3435, The Netherlands;1. Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan;2. Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama 641-8510, Japan |
| Abstract: | PurposeTo evaluate the safety and outcomes of endovascular recanalization of chronic total occlusions (CTOs) of the superior mesenteric artery (SMA) in patients with chronic mesenteric ischemia (CMI).Materials and MethodsA single-institution retrospective review was performed of 47 consecutive patients (18 male, 29 female) who underwent endovascular stent placement for CTOs of the SMA between February 2006 and November 2012. All patients had symptoms of CMI. Procedural and follow-up data were collected for assessment of technical success, safety, and outcome.ResultsTechnical success was achieved in 41 of 47 patients (87%). Forty-two of the 47 procedures were performed from a femoral approach. Fifteen patients underwent concurrent revascularization of the celiac artery. All patients who underwent successful recanalization reported symptomatic improvement. Kaplan–Meier analysis revealed primary freedom from symptomatic recurrence of 95% at 12 months and 78% at 24 months. Symptomatic recurrence was observed in seven patients, all of whom underwent successful assisted or secondary endovascular procedures. Secondary freedom from symptomatic recurrence rates were 100% at 12 months and 88% 24 months. There were three (7%) minor access-related complications and no major complications.ConclusionsEndovascular stent-assisted recanalization of chronic SMA occlusions is safe and effective, with an acceptable rate of technical success and excellent midterm clinical outcomes. |
| Keywords: | CMI"} {"#name":"keyword" "$":{"id":"key0010"} "$$":[{"#name":"text" "_":"chronic mesenteric ischemia CTO"} {"#name":"keyword" "$":{"id":"key0020"} "$$":[{"#name":"text" "_":"chronic total occlusion SMA"} {"#name":"keyword" "$":{"id":"key0030"} "$$":[{"#name":"text" "_":"superior mesenteric artery |
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