Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease

Oderich, Gustavo S.; Erdoes, Luke S.; LeSar, Christopher J.; Mendes, Bernardo C.; Gloviczki, Péter; Cha, Stephen; Duncan, Audra A.; Bower, Thomas C.

doi:10.1016/j.jvs.2013.05.013

Cited by 124 publications

(76 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4). In order to avoid the consequences of a potential vessel perforation as well as to reduce the rate of late restenosis, stent grafts can be deployed as well [21]. …”

Section: Are Endovascular Techniques a Reasonable Treatment Option?mentioning

confidence: 99%

The Ongoing Challenge of Acute Mesenteric Ischemia

et al. 2018

View full text Add to dashboard Cite

Background: The lethality of acute mesenteric ischemia (AMI) remains quite high with 50-70%. The main reasons for that are the fact that AMI is rarely taken into consideration by the differential diagnosis of acute abdomen, the time-consuming diagnostic process, and the lack of a standardized therapeutic concept. The present interdisciplinary review aims to increase awareness among physicians and to help improve clinical outcomes. Methods: This clinical therapeutic review is based on author expertise as well as a selective literature survey in PubMed based on the term ‘mesenteric ischemia', combined with the terms ‘arterial', ‘clinical presentation', ‘diagnosis', ‘therapy', ‘surgery', and ‘interventional radiology'. Based on these search results as well as on the guidelines of the German Society of Vascular Surgery, the American College of Cardiology, and the American Heart Association, we present an interdisciplinary treatment concept. Results: AMI is a vascular emergency that can be successfully treated only within the first hours after the onset of symptoms. Computed tomography angiography is the diagnostic method of choice. Intensive care unit treatment can prevent the occurrence of multiple organ failure. Treatment primarily consists of the revascularization of the mesenteric arteries. Endovascular techniques should be given priority, whereas signs of peritonitis or a central arterial occlusion with high thrombus load primarily require a surgical approach in order to save time and increase patient safety. Additional bowel resections can play a significant role in the treatment of intestinal sepsis. Conclusion: Prompt and goal-oriented diagnosis and consistent treatment of AMI within 4-6 h from the onset of symptoms can be decisive for the reduction of AMI-associated lethality. In order for this to happen, a standardized concept of emergency treatment needs to be implemented.

show abstract

“…4). In order to avoid the consequences of a potential vessel perforation as well as to reduce the rate of late restenosis, stent grafts can be deployed as well [21]. …”

Section: Are Endovascular Techniques a Reasonable Treatment Option?mentioning

confidence: 99%

The Ongoing Challenge of Acute Mesenteric Ischemia

et al. 2018

View full text Add to dashboard Cite

show abstract

“…In general, while the reintervention rate appears higher for ET, the method has been considered cost-effective and provides an improvement in quality-adjusted life years [27] . Some authors have suggested ET as first-line treatment, with the caveat that angioplasty should be combined with stenting using covered stents rather than bare-metal stents (based on limited retrospective data), as this approach seems to deliver better freedom from restenosis and symptom recurrence [18,28] . The results of our study are similar to those previously reported in the literature, finding that OT delivers better midand long-term patency rates.…”

Section: Resultsmentioning

confidence: 99%

Chronic Mesenteric Ischemia: Patient Outcomes Using Open Surgical Revascularization

Wagenhäuser

Meyer-Janiszewski²,

Dueppers³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

Background: Chronic mesenteric ischemia (CMI) is a rare disease. Open treatment (OT) remains a valuable treatment option. We analyzed patient outcomes after OT and investigated health-related quality of life (HRQoL). Methods: Data were analyzed retrospectively. The investigation period was from January 1, 2001, to December 31, 2014. We investigated mortality and patency rates using Kaplan-Meier analysis. HRQoL was measured using a 36-item health survey. Various statistical methods were employed. Results: A total of 100 patients (celiac trunk [TC: n = 23], superior mesenteric artery [SMA: n = 26], or both [n = 51]) were included. Median follow-up was 5 ± 35 months. One-year survival rate for TC was 75 ± 11%, for SMA: 79 ± 10%, and for both: 96 ± 3%. TC 5-year survival was 75 ± 11% (SMA: 57 ± 16%: both: 80 ± 8%). Obesity and the length of hospital stay were independently associated with patient survival (p < 0.05). Primary 1-year patency rate was 60 ± 13% for TC (SMA: 86 ± 10%; both: 71 ± 8%) and secondary 1-year patency rate was 84 ± 9% for TC (SMA: 100%; both: 79 ± 7%). HRQoL was inferior compared to the German normative data (p < 0.05). Conclusion: CMI overlaps between gastrointestinal and vascular surgery. OT is safe, and simultaneous revascularization of the TC and the SMA does not affect mortality. Patients would not necessarily benefit from OT in terms of HRQoL.

show abstract

“…Options include the iCast covered stent (Atrium, Hudson, NH). Additionally, in a recent comparison of CS versus BS, CS were associated with improved freedom from restenosis (92% vs 53%), symptom recurrence (92% vs 50%), primary patency at 3 years (92% vs 52%) (12). Further, improved rates of restenosis, symptom recurrence, and patency were also seen in patients undergoing reintervention for chronic mesenteric ischemia.…”

Section: Procedural Stepsmentioning

confidence: 93%