Mahmud Saedon1, Athanasios Saratzis2, Ahmed Karim3, Steve Goodyear3. 1. Division of Metabolic and Vascular Health, University of Warwick, Coventry, United Kingdom West Midlands Vascular Society, West Midlands, United Kingdom. 2. West Midlands Vascular Society, West Midlands, United Kingdom Warwickshire Vascular and Endovascular Unit, University Hospital Coventry & Warwickshire, Coventry, United Kingdom a_saratzis@yahoo.gr. 3. West Midlands Vascular Society, West Midlands, United Kingdom Warwickshire Vascular and Endovascular Unit, University Hospital Coventry & Warwickshire, Coventry, United Kingdom.
Abstract
BACKGROUND: Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization (SR) or endovascular revascularization (ER). MATERIALS AND METHODS: Systematic review of 12 studies comparing ER and SR in CMI. Primary end point was perioperative (30 days) survival. A secondary composite end point consisted of perioperative mortality, nonfatal cardiac events, nonfatal stroke, and nonfatal bowel ischemia. Further end points included late survival, primary patency, and symptom improvement. RESULTS: The cumulative odds ratio (OR) for perioperative mortality was 0.78 (95% confidence interval [CI]: 0.40-1.50, P = .45) and 0.56 (95% CI: 0.28-1.11, P = .10) for the composite end point. The cumulative OR for survival after the 30th day was 0.83 (95% CI: 0.47-1.46), P = .51. Late primary patency was reported in 8 studies, with a cumulative OR of 3.57 (95% CI: 1.83-6.97, P = .0002)-favoring SR. CONCLUSION: In the first meta-analysis to compare ER and SR in CMI, there were no differences in mortality and morbidity. Patency rates were better following SR.
BACKGROUND:Chronic mesenteric ischemia (CMI) can be treated with surgical revascularization (SR) or endovascular revascularization (ER). MATERIALS AND METHODS: Systematic review of 12 studies comparing ER and SR in CMI. Primary end point was perioperative (30 days) survival. A secondary composite end point consisted of perioperative mortality, nonfatal cardiac events, nonfatal stroke, and nonfatal bowel ischemia. Further end points included late survival, primary patency, and symptom improvement. RESULTS: The cumulative odds ratio (OR) for perioperative mortality was 0.78 (95% confidence interval [CI]: 0.40-1.50, P = .45) and 0.56 (95% CI: 0.28-1.11, P = .10) for the composite end point. The cumulative OR for survival after the 30th day was 0.83 (95% CI: 0.47-1.46), P = .51. Late primary patency was reported in 8 studies, with a cumulative OR of 3.57 (95% CI: 1.83-6.97, P = .0002)-favoring SR. CONCLUSION: In the first meta-analysis to compare ER and SR in CMI, there were no differences in mortality and morbidity. Patency rates were better following SR.
Authors: Louisa Jd van Dijk; Desirée van Noord; Annemarie C de Vries; Jeroen J Kolkman; Robert H Geelkerken; Hence Jm Verhagen; Adriaan Moelker; Marco J Bruno Journal: United European Gastroenterol J Date: 2018-12-04 Impact factor: 4.623
Authors: Louisa J D van Dijk; Jihan Harki; Desirée van Noord; Hence J M Verhagen; Jeroen J Kolkman; Robert H Geelkerken; Marco J Bruno; Adriaan Moelker Journal: Trials Date: 2019-08-20 Impact factor: 2.279