Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease

Gustavo S. Oderich, Luke S. Erdoes, Christopher Lesar, Bernardo C. Mendes, Peter Gloviczki, Stephen Cha, Audra A. Duncan, Thomas C. Bower

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

Objective: To compare outcomes of mesenteric angioplasty and stenting using iCAST covered stents (CS; Atrium, Hudson, NH) or bare metal stents (BMS) in patients with chronic mesenteric ischemia (CMI). Methods: We reviewed the clinical data of 225 patients (65 male and 160 female; mean age, 72 ± 12 years) treated for CMI at two academic centers (2000-2010). Outcomes were analyzed in patients who had primary intervention or reintervention using BMS (n = 164 patients/197 vessels) or CS (n = 61 patients/67 vessels). End points were freedom from restenosis, symptom recurrence, reinterventions, and patency rates. Results: Patients in both groups had similar demographics, cardiovascular risk factors, and extent of disease. In the primary intervention group (mean follow-up, 29 ± 12 months), patients treated by CS had higher freedom from restenosis (92% ± 6% vs 53% ± 4%; P =.003), symptom recurrence (92 ± 4% vs 50 ± 5%; P =.003), reintervention (91% ± 6% vs 56% ± 5%; P =.005), and better primary patency at 3 years (92% ± 6% vs 52% ± 5%; P <.003) than for BMS. In the reintervention group (mean follow-up, 24 ± 9 months), patients treated by CS had higher freedom from restenosis (89% ± 10% vs 49% ± 14%; P <.04), symptom recurrence (100% vs 64%± 9%; P =.001), and reintervention (100% vs 72% ± 9%; P =.03) at 1 year, and a trend toward improved primary patency at 1 year (100% vs 63% ± 9%; P =.054). Secondary patency rates were similar in both groups. Conclusions: In this nonrandomized study, CS were associated with less restenosis, recurrences, and reinterventions than BMS in patients undergoing primary interventions or reinterventions for CMI.

Original languageEnglish (US)
Pages (from-to)1316-1324
Number of pages9
JournalJournal of vascular surgery
Volume58
Issue number5
DOIs
StatePublished - Nov 2013

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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