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 SS14. Comparison of Covered Stents vs. Bare Metal Stents for Treatment of Chronic Atherosclerotic Mesenteric Arterial Disease

​Gustavo S. Oderich1, Luke Erdoes2, Christopher LeSar2, Peter Gloviczki1, Audra A. Duncan1, Manju Kalra1, Sanjay Misra1, Stephen Cha1, Thomas C. Bower1
1Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN; 2University of Tennessee, Chattanooga, TN.

OBJECTIVES: To compare outcomes of mesenteric angioplasty and stenting (PTAS) using iCast covered stents (C-PTAS; Atrium, Hudson, NH) ) or bare metal stents (BM-PTAS) 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 yrs) treated for CMI (2000-2010). Outcomes were analyzed in patients who had primary intervention or re-intervention using BM-PTAS (n=164 patients/197 vessels) or C-PTAS (n=61 patients/67 vessels). End-points were freedom from restenosis, recurrence and re-intervention, and primary and secondary patency rates.

RESULTS: Patients in both groups had similar demographics, cardiovascular risk factors and extent of disease. Mean follow up was 27±12 months. Patients treated by C-PTS had less restenosis, recurrences and re-interventions compared to those treated by BM-PTAS, both in the primary intervention and in the re-intervention groups (p<0.05); primary patency at 2 years was significantly higher for C-PTAS compared to BM-PTAS in the primary intervention group (91±6 vs. 60±5; p<0.003).

CONCLUSIONS: In this non-randomized study covered stents were associated with less restenosis, recurrences and re-interventions in patients undergoing primary interventions or re-interventions for CMI.

AUTHOR DISCLOSURES: T. C. Bower, Nothing to disclose; S. Cha, Nothing to disclose; A. A. Duncan, Nothing to disclose; L. Erdoes, Nothing to disclose; P. Gloviczki, Nothing to disclose; M. Kalra, Nothing to disclose; C. LeSar, Nothing to disclose; S. Misra, Nothing to disclose; G. S. Oderich, Nothing to disclose.

BARE-METAL STENTS
(n=164 pts/197 vessels)
COVERED STENTS
(n=61 pts/ 67 vessels)
p-Value
%±SD*
PRIMARY INTERVENTION GROUP
n=149 pts/181 vessels
n=42 pts/45 vessels
Freedom from restenosis
53±4
92±6
.003
Freedom from recurrence
58±4
95±5
0.001
Freedom from re-intervention
59±5
95±5
0.001
Primary patency
60±5
91±6
0.003
Secondary patency
95±2
100
0.46
RE-INTERVENTION GROUP
n=15 pts/16 vessels
21 pts/22 vessels
Freedom from restenosis
49±14
89±10
0.04
Freedom from recurrence
44±14
89±10
0.001
Freedom from re-intervention
56±12
89±10
0.03
Primary patency
45±14
60±12
0.08
Secondary patency
100
82±10
0.10
*2-year Kaplan-Meier estimates

 

Posted April 2012

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