Retrograde open mesenteric stenting for acute mesenteric ischemia

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Gastroenterology

Background:

• Acute mesenteric ischemia (AMI) is a critical condition with high mortality.
• Percutaneous mesenteric artery stenting (PMAS) is the primary endovascular treatment for AMI.
• PMAS is not always technically feasible, necessitating alternative approaches.

Purpose of the Study:

• To evaluate the clinical outcomes of Retrograde Open Mesenteric Stenting (ROMS) in patients with AMI.
• To assess the technical success, mortality, patency, and complication rates of ROMS.
• To determine ROMS's reliability as an alternative to PMAS when it is not feasible.

Main Methods:

• Prospective registry of patients undergoing emergent mesenteric revascularization for AMI (January 2007 - September 2011).
• Data collection included technical success, mortality, patency, clinical success, and complications at 30 days, 6 months, and 12 months.
• Analysis of 15 patients treated with ROMS (either directly or after failed PMAS).

Main Results:

• Technical success was achieved in 14 out of 15 patients.
• At 30 days, mortality was 20% and primary patency was 92%.
• At 12 months, mortality remained 20%, primary patency was 83%, and clinical success was 67%.

Conclusions:

• Retrograde Open Mesenteric Stenting (ROMS) is a reliable alternative for Acute Mesenteric Ischemia (AMI) when PMAS is not feasible.
• ROMS is associated with a relatively low mortality and morbidity rate in this patient cohort.
• Despite its effectiveness, AMI remains a devastating event requiring prompt intervention.