Endovascular Management of Chronic Mesenteric Ischemia: Technical Success and Long-Term Outcomes over 10 Years in a...

The primary objective of this study is to evaluate the immediate technical success, 30-day mortality, and long-term outcomes of mesenteric artery angioplasty and/or stenting performed on patients suffering from symptomatic chronic mesenteric ischemia at a single Tertiary Center in the United Kingdom, over a 10-year period from 2012 to 2022.

This retrospective study involved the collection of data from electronic hospital records. The primary outcomes assessed were early immediate technical success (defined as patent vessels with less than 30% residual stenosis after endovascular management) and (<30 days) mortality. Secondary outcomes included symptom recurrence following the initial intervention, reintervention rates within a 2-year period, and overall mortality tracked over a 10-year timeframe.

A total of 53 patients underwent surgical treatment for 60 vessels. The primary outcomes revealed a 30-day mortality rate of 3.7% (2/53 patients) and an immediate technical success rate of 96.2% (51/53 patients). Secondary outcomes indicated a reintervention rate at 2 years of 18.9% (10/53 patients) and a symptom recurrence rate of 11% (6/53 patients) within 1 year. The mortality rates observed were 15.1% (8/53 patients) at 2 years and 37.7% (20/53 patients) at 10 years. Seventy-one point six percent (38/53 patients) did not require further revascularization after 2 years. Among those who survived beyond 1 year, 71.6% (38/53 patients) demonstrated successful treatment without the necessity for further revascularization at the 2-year mark.

Endovascular management of the superior mesenteric artery for chronic mesenteric ischemia (CMI) represents a safe therapeutic option, yielding immediate symptom relief. It has good technical success rate, and 30-day mortality is within acceptable range. The observed overall mortality associated with elective CMI procedures in this cohort appears to be more closely linked to general health decline and coexisting cardiovascular morbidities rather than the procedural interventions or mesenteric disease itself. In patients who survived beyond 1 year, mortality was primarily associated with respiratory ailments or malignancies.