Open Mesenteric Interventions Are Equally Safe as Endovascular Interventions and Offer Better Midterm Patency for XXXX .

@entity1 @entity5327 @entity260
BACKGROUND: Endovascular (EV) techniques are being advocated as the preferred method for mesenteric interventions because of their safety profile. However, midterm and long-term results are thought to be inferior to open interventions. We sought to compare our institutional experience with treatment of acute and chronic @entity5327 (AMI and CMI, respectively) using EV and open techniques. METHODS: The medical records of open and EV mesenteric procedures performed at a single center were queried from 2002 to 2012. Demographic, perioperative, and follow-up data were extracted and analyzed. RESULTS: Thirty-eight @entity1 underwent EV mesenteric interventions, whereas 77 @entity1 underwent open revascularization. The demographic and perioperative characteristics for @entity1 were similar. Most EV procedures (89.2%) comprised stenting, whereas open procedures included 25 (32.1%) antegrade bypasses, 38 (48.7%) retrograde bypasses, 8 (10.3%) thromboembolectomies, and 7 (9%) transaortic endarterectomies. @entity260 , overall 30-day morbidity and mortality were not significantly different in the open and EV groups for AMI or CMI. Thirty-day mortality in AMI (n  =  34) was 38.2% (EV: 45.5% vs. open: 34.8%; P  =  nonsignificant). There was no mortality in either group for CMI @entity1 . Mean follow-up was much longer for the open procedures (34.9 vs. 12.7  months, P  =  0.004). Primary and secondary patency rates were better for open revascularization for CMI @entity1 . CONCLUSIONS: Open revascularizations are equally safe as EV interventions for AMI and CMI. Patency of open revascularization for CMI is better than EV procedures at midterm follow-up.
