Moderate risk of all-cause mortality and stent-related complications in patients undergoing endovascular treatment for chronic mesenteric ischemia

Objective: This study sought to review clinical outcomes in patients who underwent endovascular treatment for chronic mesenteric ischemia (CMI). Methods: A retrospective study was performed from June 1, 2019, to October 31, 2023, including consecutive CMI patients undergoing endovascular revascularization at a single institution. The primary end point was the 30-day mortality rate. The secondary end points were the 12-month mortality, primary patency, primary-assisted patency, and secondary patency rate . Descriptive statistics were gathered for primary and secondary outcomes. Univariate and multivariable logistic regressions were performed to identify covariates associated with the primary end point. Results: Our cohort consisted of 37 patients with a mean age of 73 ± 10 years, and most were female patients (76%). There were 15 patients (41%) who had a diagnosis of acute-on-CMI. Most procedures were done semiemergently (62%) and were performed by a vascular surgeon (95%). At 30 days, there were three deaths (8%) and four additional deaths at 12 months. For our primary end point, there was a trend that advanced age (odds ratio, 1.01; 95% confidence interval, 0.93-1.09) and male sex (odds ratio, 1.31; 95% confidence interval, 0.21-8.32) were associated with 30-day mortality on univariate analysis. On multivariable logistic regression, age and sex were not associated with 30-day mortality. Our clinical outcomes show a primary patency rate of 86%, a primary-assisted patency rate of 89%, and a secondary patency rate of 92% at 12 months. Conclusions: Our study demonstrated acceptable primary stent patency in a heterogeneous population. There were trends linking advanced age and male sex to poorer outcomes. Future research should explore predictors of lower stent patency, such as small stent size and diameter, and investigate sex-based differences in larger cohorts.