The Impact of Revascularisation on Quality of Life in Chronic Mesenteric Ischemia

Abstract

Background Chronic mesenteric ischemia (CMI) is characterized by long-standing abdominal symptoms due to insufficient mesenteric circulation. Data on the effect of revascularisation on quality of life (QoL) for CMI are scarce. This study is the first to evaluate the impact of revascularisation on quality of life. Methods Seventy-nine patients with CMI or acute-on-chronic mesenteric ischemia (AoCMI) underwent an intervention of one or more mesenteric arteries between January 2010 and July 2012. QoL before and after intervention was measured with the EuroQol-5D. Preintervention questionnaires were of standard care. Postintervention data were obtained by resending a questionnaire to the patients between February and May 2013. To investigate the clinical relevance of our findings, the minimal clinically important difference (MCID) was used. Since there is no established MCID for CMI, we used the literature reference MCID of inflammatory bowel syndrome (IBS) of 0.074. Results Fifty-five (69.6%) of 79 patients returned their questionnaire and 23 (29.1%) were completely filled out. There was a significant increase of the median EQ-index score from 0.70 to 0.81 (p=0.02) and a significant reduction of symptoms in the domains usual activities (34.4%) and pain/discomfort (32.3%). There was a significant improvement of 17% in overall current health condition (VAS) (p=0.001). The MCID between baseline and postoperative EQ-5D index score was 0.162, indicating a clinically relevant improvement of quality of life after revascularisation. Conclusion Quality of life of CMI patients is improved after mesenteric artery revascularisation.

Acute Mesenteric Ischemia: Preexisting Comorbidity Determines Short-Term Outcome and Quality of Life in Long-Term Survivors

“…Data about QoL after acute occlusive mesenteric ischemia are missing. Only one publication exists for QoL after intervention in chronic mesenteric ischemia [28]. To the best of our knowledge, this study reports for the first time QoL data in AMI survivors with a median follow-up of 4 years.…”

Chronic mesenteric ischemia: Clinical practice guidelines from the Society for Vascular Surgery

“…82 In contrast, revascularization, either open or endovascular, has been associated with excellent results in terms of both symptomatic relief and long-term graft or mesenteric vessel patency. 31,35,83,84 Notably, Blauw et al 85 surveyed patients before and after revascularization for CMI using the Euroqol-5D survey tool and reported that revascularization was associated with an overall improvement in quality of life with improvement within the activities and pain/discomfort domains.…”

Ischemic bowel disease in 2021

“…These include body mass index > 25 kg/m, smoking, peripheral artery disease, hypertensive chronic kidney disease, and open mesenteric bypass with a venous graft[ 130 ]. Blauw et al [ 131 ] did a retrospective study on the impact of revascularization in patients with CMI and found that mesenteric artery revascularization significantly improved their quality of life[ 131 ].…”