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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Chronic Mesenteric Ischemia: Patient Outcomes Using Open Surgical Revascularization
Markus U Wagenhäuser1, Yvonne K Meyer-Janiszewski, Philip Dueppers
1Department of Vascular and Endovascular Surgery, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Insights
Open treatment for chronic mesenteric ischemia (CMI) is safe, with good survival rates when revascularizing the celiac trunk (TC) and superior mesenteric artery (SMA). However, patients may not experience improved quality of life post-treatment.
Area of Science:
- Gastrointestinal Surgery
- Vascular Surgery
- Ischemia Research
Background:
- Chronic mesenteric ischemia (CMI) is a rare but serious condition.
- Open treatment (OT) remains a viable option for CMI management.
- Analysis of patient outcomes and quality of life after OT is crucial.
Purpose of the Study:
- To evaluate patient outcomes following open treatment for CMI.
- To assess the health-related quality of life (HRQoL) in CMI patients treated with OT.
- To investigate the impact of simultaneous revascularization of the celiac trunk (TC) and superior mesenteric artery (SMA) on mortality.
Main Methods:
- Retrospective analysis of patient data from 2001 to 2014.
- Kaplan-Meier analysis for mortality and patency rates.
- Utilized the 36-item health survey for HRQoL assessment.
Main Results:
- 100 patients included: TC (n=23), SMA (n=26), both (n=51).
- 1-year survival rates ranged from 75% (TC) to 96% (both TC/SMA). 5-year survival showed variations. Obesity and hospital stay length impacted survival.
- 1-year primary patency rates varied by vessel (TC: 60%, SMA: 86%, both: 71%), with higher secondary rates. HRQoL was significantly lower than German normative data.
Conclusions:
- Open treatment for CMI is a safe procedure.
- Simultaneous revascularization of TC and SMA does not negatively impact mortality.
- Open treatment for CMI does not necessarily lead to improved HRQoL.
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.
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