Bulut T, Oosterhof-Berktas R, Geelkerken R H, Brusse-Keizer M, Stassen E J, Kolkman J J
Department of Radiology, Medisch Spectrum Twente, Enschede, The Netherlands.
Department of Radiology, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Radiology Martini Ziekenhuis, Groningen, The Netherlands.
Eur J Vasc Endovasc Surg. 2017 Apr;53(4):583-590. doi: 10.1016/j.ejvs.2016.12.036. Epub 2017 Feb 21.
Over the past decade, primary percutaneous mesenteric artery stenting (PMAS) has become an alternative to open revascularisation for treatment of mesenteric ischaemia. Institutes have presented favourable short-term outcomes after PMAS, but there is a lack of data on long-term stent patency.
One hundred and forty-one patients treated by PMAS for acute and chronic mesenteric ischaemia over an 8 year period were studied. Anatomical success was assessed by duplex ultrasound and/or CT angiography. A stenosis ≥70% was considered to be a failure.
Eighty-six coeliac arteries (CA) and 99 superior mesenteric arteries (SMA) were treated with PMAS in 141 patients. Nine CAs (10%) and 30 SMAs (30%) were occluded at the time of treatment. Median follow-up was 32 months (IQR 20-46). The overall primary patency rate at 12 and 60 months was 77.0% and 45.0%. The overall primary assisted patency rate was 90.3% and 69.8%. Overall secondary patency was 98.3% and 93.6%.
This study shows excellent long-term secondary patencies after PMAS, comparable with published data on long-term patencies after open surgical revascularisation.
在过去十年中，经皮肠系膜动脉支架置入术（PMAS）已成为肠系膜缺血开放血管重建治疗的替代方法。各机构报告了PMAS术后良好的短期疗效，但缺乏关于长期支架通畅性的数据。
对8年间接受PMAS治疗急性和慢性肠系膜缺血的141例患者进行研究。通过双功超声和/或CT血管造影评估解剖学成功率。狭窄≥70%被视为失败。
141例患者中，86例腹腔干动脉（CA）和99例肠系膜上动脉（SMA）接受了PMAS治疗。治疗时，9例CA（10%）和30例SMA（30%）闭塞。中位随访时间为32个月（四分位间距20 - 46个月）。12个月和60个月时的总体原发性通畅率分别为77.0%和45.0%。总体原发性辅助通畅率分别为90.3%和69.8%。总体继发性通畅率分别为98.3%和93.6%。
本研究显示PMAS术后具有出色的长期继发性通畅率，与开放手术血管重建术后长期通畅性的已发表数据相当。
