• Timur P Sarac, Ozcan Altinel, Vikram Kashyap, Jams Bena, Sean Lyden, Sunita Sruvastava, Matthew Eagleton, and Daniel Clair.
• Cleveland Clinic Lerner School of Medicine, Cleveland, Ohio 44195, USA. SaracT@ccf.org
• J. Vasc. Surg. 2008 Mar 1; 47 (3): 485-491.

PurposePercutaneous angioplasty and stenting (PTAS) is emerging as a therapeutic option for patients with chronic mesenteric ischemia. This study evaluated patency and mortality, and their relationship between degree of vessel occlusion (stenotic or totally occluded), stent characteristics, and comorbidities in patients who were treated with PTAS of the visceral vessels for chronic mesenteric ischemia.MethodsA retrospective review was performed of the records of all patients who underwent PTAS of the celiac, superior mesenteric, or inferior mesenteric arteries, or both, for symptomatic chronic mesenteric ischemia between January 2001 and December 2005. Patient demographics, lesion characteristics (stenosis or occlusion), interventional details, and early and late mortality rates were recorded. Cumulative mortality and patency rates and factors associated with outcomes were determined using Kaplan-Meier method and Cox proportional hazards modeling.ResultsEighty-seven mesenteric vessels (57 superior mesenteric, 23 celiac, and 7 inferior mesenteric arteries) were treated in 65 patients (29 men and 36 women). Completely occluded vessels were treated in 18 patients (28%), and >60% stenosis was treated in 47 patients (72%). Mesenteric angina was the most common symptom (97%). For the entire series, the cumulative 1-year results were primary patency, 65% (95% confidence interval [CI], 50%-80%); primary assisted patency, 97% (95% CI, 92%-100%); secondary patency, 99% (95% CI, 96%-100%); and survival, 89% (95% CI, 80%-98%). All deaths occurred ConclusionsFor patients with chronic mesenteric ischemia, the results of endovascular treatment of occluded mesenteric arteries are indistinguishable from those treated for stenotic vessels. Patients requiring bowel resection are less likely to survive, and those with chronic obstructive pulmonary disease or who had femoral access have higher reintervention rates.

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