Early Peak Systolic Velocity and Trend Variation Predict Stent Patency in Chronic Mesenteric Ischemia and Propose a...

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Medical Imaging

Background:

• Stenting of the superior mesenteric artery (SMA) and celiac artery is a common treatment for chronic mesenteric ischemia (CMI).
• Duplex ultrasound (DUS) is recommended by the Society for Vascular Surgery (SVS) for surveillance after stenting.

Purpose of the Study:

• To evaluate if early postoperative peak systolic velocity (PSV) and its progression predict primary patency (PP) loss after SMA stenting.
• To establish PSV progression as a clinically meaningful marker for restenosis.

Main Methods:

• Retrospective analysis of 179 patients (240 vessels) undergoing SMA or celiac artery stenting.
• Early PSV measured within 3 months post-stenting; progression defined by absolute and relative increases.
• Cox proportional hazards and time-dependent ROC analyses used to assess PSV and PP loss.

Main Results:

• Higher early PSV independently predicted PP loss; each 10 cm/s SMA-PSV increase raised PP loss risk by 5% (HR 1.05).
• Progressive PSV increase (≥100 cm/s or ≥50% rise) tripled stent failure risk (HR 3.26-3.58).
• PSV trends showed superior predictive value over isolated velocity thresholds.

Conclusions:

• Elevated early PSV and progressive increases are strong predictors of mesenteric stent failure.
• PSV progression is a clinically significant marker for restenosis.
• Findings support a surveillance framework based on PSV trends for mesenteric stents.