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Surgical versus endovascular reconstruction for chronic mesenteric ischemia: a contemporary UK series.

Davies, Robert S M and Wall, Michael L and Silverman, Stanley H and Simms, Malcolm H and Vohra, Rajiv K and Bradbury, Andrew W and Adam, Donald J (2009) Surgical versus endovascular reconstruction for chronic mesenteric ischemia: a contemporary UK series. Vascular and endovascular surgery, 43 (2). pp. 157-64. ISSN 1538-5744. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs

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Official URL: http://ves.sagepub.com/content/43/2/157.long

Abstract

OBJECTIVE

To assess the outcome of surgical (SR) and endovascular (ER) reconstruction for chronic mesenteric ischemia (CMI).

METHODS

Retrospective review of consecutive patients who underwent SR or ER for CMI in 3 UK vascular surgery units between 1996 and 2006. Early (<30 days; technical success, morbidity, mortality, length of hospital stay) and late (>30 days) outcomes (symptom recurrence, vessel/graft patency, reintervention, mortality) were assessed.

RESULTS

A total of 27 patients underwent 32 reconstructions (SR = 17, ER = 15). A total of 44 of 56 (79%) diseased arteries underwent SR (n = 26; bypass = 24, reimplantation = 2; occlusion = 16, stenosis = 10) or ER (n = 18; stenosis = 16, occlusion = 2). Perioperative mortality for SR and ER was 6% and 0%, respectively (P > or = .99). Hospital stay was shorter following ER (mean, 4.3 vs. 14.2 days, P = .0003). Mean (range) follow-up for SR and ER was 34 (1-94) and 34 (0-135) months, respectively. At 2 years, SR demonstrated superior secondary patency (100% vs. 65%) and clinical patency (100% vs. 73%).

CONCLUSIONS

Surgical mesenteric reconstruction is associated with significantly longer hospital stay, but superior long-term outcome compared to endovascular reconstruction.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Subjects: WG Cardiovascular system. Cardiology
WO Surgery
Divisions: Planned IP Care > Vascular
Related URLs:
Depositing User: Sophie Rollason
Date Deposited: 05 Jun 2014 10:46
Last Modified: 17 Jun 2014 10:56
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/160

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