Endovascular Treatment Approaches In Mesenteric Ischemia: A Prospective Study.

Abstract

Background: Mesenteric ischemia is a life-threatening vascular emergency marked by reduced intestinal blood flow, and delayed intervention often leads to bowel necrosis and high mortality. Endovascular treatments have emerged as less invasive, rapid, and effective options compared to open surgical revascularization. This study evaluates the outcomes of various endovascular approaches in patients presenting with mesenteric ischemia.

Aims & Objectives: To evaluate the effectiveness, safety, and early clinical outcomes of endovascular treatment in 30 patients with mesenteric ischemia.

Materials and Methods: A prospective observational study was conducted on 30 consecutive patients diagnosed with acute or chronic mesenteric ischemia at a tertiary care center. CT angiography confirmed diagnosis in all cases. Endovascular procedures included balloon angioplasty, primary stenting, aspiration thrombectomy, and catheter-directed thrombolysis. Primary endpoints were technical success, clinical improvement, complication rates, need for laparotomy, and 30-day mortality. Patients were followed clinically and radiologically for 30 days post-procedure.

Results: Among the 30 patients (mean age 59 years), 18 presented with acute and 12 with chronic mesenteric ischemia. Technical success was achieved in 90% (27/30) of cases, and 80% (24/30) demonstrated significant symptom relief and lactate improvement. Four acute cases required laparotomy for non-viable bowel. Minor complications occurred in three patients, with no major procedure-related adverse events. The 30-day mortality rate was 10%, largely attributable to delayed presentation.

Conclusion: Endovascular therapy provides a high success rate, low complication profile, and favourable early outcomes, making it a preferred first-line treatment for mesenteric ischemia when performed promptly.