Endovascular Management of Chronic Mesenteric Ischemia: Technical Success and Long-Term Outcomes Over 10 Years in a UK Tertiary Centre.

Objective: The primary objective of this study is to evaluate the immediate technical success, 30-day mortality, and long-term outcomes of mesenteric artery angioplasty and/or stenting performed on patients suffering from symptomatic chronic mesenteric ischemia at a single Tertiary Centre in the UK, over a ten-year period from 2012 to 2022.

Methods: This retrospective study involved the collection of data from electronic hospital records. The primary outcomes assessed were early immediate technical success (defined as patent vessels with less than 30% residual stenosis after endovascular management) and (< 30 days) mortality. Secondary outcomes included symptom recurrence following the initial intervention, re-intervention rates within a two-year period, and overall mortality tracked over a ten-year timeframe.

Results: A total of fifty-three patients underwent surgical treatment for sixty vessels. The primary outcomes revealed a 30-day mortality rate of 3.7% (2 /53 patients) and an immediate technical success rate of 96.2% (51/53 patients). Secondary outcomes indicated a re-intervention rate at two years of 18.9% (10/53 patients) and a symptom recurrence rate of 11% (6/53 patients) within one year. The mortality rates observed were 15.1% (8/53 patients) at two years and 37.7% (20/53 patients) at ten years. 71.6% (38/53 patients) did not require further revascularisation after two years. Among those who survived beyond one year, 71.6% (38/53 patients) demonstrated successful treatment without the necessity for further revascularization at the two-year mark.

Conclusion: Endovascular management of the superior mesenteric artery (SMA) for chronic mesenteric ischemia (CMI) represent a safe therapeutic option, yielding immediate symptom relief. It has good technical success rate, and 30-day mortality is within acceptable range. The observed overall mortality associated with elective CMI procedures in this cohort appears to be more closely linked to general health decline and coexisting cardiovascular morbidities rather than the procedural interventions or mesenteric disease itself. In patients who survived beyond one year, mortality was primarily associated with respiratory ailments or malignancies.