Stenting of Superior Mesenteric Artery Chronic Total Occlusions in Patients with Chronic Mesenteric Ischemia: Technical and Clinical Outcomes Grilli CJ,

Slides:

Advertisements

Similar presentations

Peripheral Arterial Disease :PAD. Introduction PAD caused by atherosclerotic occlusion of arteries to legs Prevalence 12% and increases to 20% if persons.

Advertisements

“Real World”: SVG, De Novo or Restenotic Coronary Artery Lesions Chronic Stable Angina, Silent Ischemia, Acute Coronary Syndromes Vessel Diameters:

Single Center Experience with Drug Eluting Stents for Infrapopliteal Occlusive Disease in Patients with Critical Limb Ischemia: Mid-term follow up Robert.

Aggressive Management of Chronic Deep Venous Thrombosis: Technical and Clinical Outcomes Mark J. Garcia M.D. FSIR C Grilli, M McGarry, M Ali, D Agriantonus,

FRACTIONAL FLOW RESERVE versus ANGIOGRAPHY

Ischemic Heart Diseases IHD

Viabahn Covered Stents for Cephalic Arch Stenosis Can Improve Patency and Longevity of Upper Arm AV Fistulas Toufic Safa, MD, FACS Vascular & Endovascular.

Elise Wood Stress Management. Narrowing of the walls of the arteries Excessive plaque build up Disrupts blood flow Potential cardiovascular complications.

Superficial Femoral Artery Stents - Bare, Covered, or Drug-Coated – “The Data and The HYPE” Dennis F. Bandyk, MD Division of Vascular & Endovascular Surgery.

“Outpatient Arteriography and Arterial Intervention in Octogenarians. Is It Safe?” George G. Hartnell Baystate Medical Center Springfield, MA Safe at Any.

Long-term Follow-up of Aortic Intramural Hematomas and Penetrating Ulcers Alan S. Chou, BA, Bulat A. Ziganshin, MD, Paris Charilaou, MD, Maryann Tranquilli,

Acute Mesenteric Ischemia and Infarction

DIABETES trial P Jiménez-Quevedo, M Sabaté, DJ Angiolillo, JA Gómez-Hospital, R Hernández-Antolín, J Goicolea, F Alfonso, C Bañuelos, J Escaned, R Moreno,

Stent Assisted Balloon Induced Intimal Disruption and Relamination in Aortic Dissection Repair: The STABILISE Concept Sophie C. Hofferberth 1, Andrew E.

Simultaneous Coronary Artery Bypass and Carotid Endarterectomy Ye zhidong, Liu Peng Department of Cardiovascular Surgery China-Japan Friendship Hospital.

One stage coronary and peripheral intervention Pawel Buszman, MD, American Heart of Poland, Ustron Silesian Medical School, Katowice.

Chaim Lotan MD, Yaron Almagor MD, Karel Kuiper MD, M.J. Suttorp MD, William Wijns MD The SICTO Study CYPHER TM Sirolimus-eluting stent in Chronic Total.

Evaluation of ReeKross balloon catheter in treating iliofemoral artery chronic total occlusions Xinwu Lu Vascular Center of Shanghai Jiaotong University.

The Radial Artery Patency Study Investigators Radial Artery and Saphenous Vein Patency more than 5-years Following Coronary Artery Bypass Surgery: Results.

Chapter 14 Lesson 2 Heart Disease Next >> Teacher’s notes are available in the notes section of this presentation.

American College of Surgeons Presenter Disclosure Slide Chang Shu 2010 Clinical Congress American College of Surgeons ♦ Division of Education.

The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery: The SYNTAX Study One Year Results of the PCI and CABG Registries.

Atherosclerotic Disease of the Carotid Artery Atherosclerosis is a degenerative disease of the arteries resulting in plaques consisting of necrotic cells,

Endovascular treatment on tandem lesions of cranial arteries Xiao-Long Zhang, MD, PhD Department of Radiology Huashan Hospital,Fudan University Shanghai.

LONG-TERM OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION FOR UNPROTECTED LEFT MAIN CORONARY ARTERY DISEASE: INITIAL CLINICAL EXPERIENCE. Graidis Ch. 1,

Carotid Stent Presentation

Endovascular Treatment of Atherosclerotic Popliteal Artery Lesions – Balloon Angioplasty versus primary Stenting: A prospective, multi-centre, randomised.

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki.

Chronic pelvic pain Journal Club 17 th June 2011 Dr Claire Hoxley (GPST1) Dr Harpreet Rayar (GPST2)

Long-Term Clinical Outcome After Emergency MR-based Reperfusion Therapy for Acute Basilar Artery Occlusion Department of Stroke Treatment, Shonan Kamakura.

MESENTERIC ARTERY STENOSIS PRESENTING AS SEVERE EROSIVE GASTRODUODENITIS: A RARE CASE REPORT WITH LONG TERM FOLLOW-UP TITLE Sri Jayadeva Institute Of Cardiovascular.

The GREAT Trial. The Grampian Region Early Anistreplase Trial Reference Zahringer M, Sapoval M, Pattynama PM, et al. Sirolimus-eluting versus bare-metal.

Date of download: 6/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Three-Year Outcome of Endovascular Treatment of Superficial.

Mesenteric Ischemia: A Minimally Invasive Approach

Renal vascular disease

VISCERAL ARTERY STENTING in CHRONIC MESENTERIC ISCHEMIA (CMI)

Complex Ostial Disease of the Aortic Arch Vessels

Michael Siah, M.D. Medstar Georgetown University Hospital

Treatment of iliac vein obstruction

Angiographic Features of Atherosclerotic Superficial Femoral Artery Disease in Diabetics and Non-diabetics Presenting with Claudication Atif Mohammad,

Treatment of iliac vein obstruction

Ultrasound evaluation of the RENAL ARTERIES and the kidney

Patients with chronic gastrointestinal ischemia have a higher cardiovascular disease risk and mortality Aria Sana, Désirée van Noord, Peter B.F. Mensink,

Retrograde open mesenteric stenting for acute mesenteric ischemia

The Role of Interventional Treatment for The Failing Grafts

Mel J. Sharafuddin, MD, Rachael M. Nicholson, MD, Timothy F

Chronic Mesenteric Ischemia: A Rare Cause of Chronic Abdominal Pain

Inferior Mesenteric Artery Stenting as a Novel Treatment for Chronic Mesenteric Ischemia in Patients with an Occluded Superior Mesenteric Artery and Celiac.

Section 5: Intervention and drug therapy

Results ASA score: Epidemiological data: 8 patients: 7 men and 1 woman

FAIR Trial design: Patients with SFA in-stent restenosis (ISR) were randomized to either a paclitaxel-coated balloon (DCB) (dose 3.5 μg/mm2) or routine.

Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease Gustavo S. Oderich, MD, Luke.

Mel J. Sharafuddin, MD, Rachael M. Nicholson, MD, Timothy F

Mesenteric artery complications during angioplasty and stent placement for atherosclerotic chronic mesenteric ischemia Gustavo S. Oderich, MD, Tiziano.

Open surgical and endovascular treatment of superior vena cava syndrome caused by nonmalignant disease Manju Kalra, MBBS, Peter Gloviczki, MD, James.

Melanie K. Rose, MD, Benjamin J. Pearce, MD, Thomas C

Application of duplex ultrasound imaging in determining in-stent stenosis during surveillance after mesenteric artery revascularization Aaron C. Baker,

Carotid-subclavian bypass grafting with polytetrafluoroethylene grafts for symptomatic subclavian artery stenosis or occlusion: A 20-year experience

Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms Matthew J. Eagleton, MD, Matthew.

Interventions for mesenteric vasculitis

Open versus endovascular revascularization for chronic mesenteric ischemia: Risk- stratified outcomes Gustavo S. Oderich, MD, Thomas C. Bower, MD, Timothy.

Retrograde open mesenteric stenting for acute mesenteric ischemia

Stenting of the venous outflow in chronic venous disease: Long-term stent-related outcome, clinical, and hemodynamic result Peter Neglén, MD, PhD, Kathryn.

Benign superior vena cava syndrome: Stenting is now the first line of treatment Adnan Z. Rizvi, MD, Manju Kalra, MBBS, Haraldur Bjarnason, MD, Thomas.

Outcomes of reoperative open or endovascular interventions to treat patients with failing open mesenteric reconstructions for mesenteric ischemia Karina.

Sadaf S. Ahanchi, MD, Christopher L. Stout, MD, Tyler J

Vascular Surgery Michael Ricci, MD.

Reinterventions for stent restenosis in patients treated for atherosclerotic mesenteric artery disease Tiziano Tallarita, MD, Gustavo S. Oderich, MD,

Differences in anatomy and outcomes in patients treated with open mesenteric revascularization before and after the endovascular era Evan J. Ryer, MD,

Presentation transcript:

Stenting of Superior Mesenteric Artery Chronic Total Occlusions in Patients with Chronic Mesenteric Ischemia: Technical and Clinical Outcomes Grilli CJ, Fedele CR, Tahir OM, Velez JD, Wrigley C, McGarry M, Ali MA, Agriantonis D, Kimbiris G, Garcia MJ, Leung DA Christiana Care Health System, Newark DE/US

Bowel manifestation of PAD Atherosclerosis –hardening of arteries –plaque buildup  blockage Blockage of arteries supplying bowel –pain after eating –fear of food –weight loss –death Chronic Mesenteric Ischemia

Bowel arteries –celiac artery –superior mesenteric artery –inferior mesenteric artery Grading arterial blockages: –progressive atherosclerotic plaque –stenosis: 60-99% blockage amenable to endovascular stenting –occlusion: 100% blockage usually managed surgically

1. Sreenarasimhaiah J: Chronic Mesenteric Ischemia. Best Pract Res Clin Gastroenterol. 19(2):283-95, 2005 CMI 1 SMA StenosisSurgeryEndovascular SMA Occlusion SurgeryEndovascular Stent Celiac/IMA stenosis Stent SMA occlusion Background

Purpose To investigate the feasibility and effectiveness of endovascular stenting of superior mesenteric artery occlusions (100% blockages) in patients with chronic mesenteric ischemia

47 patients –18 male, 29 female –mean age 73 yrs, range All patients with clinical symptoms of CMI > 1mo Methods

72 y/o female, food fear, 45 lb weight loss

Achieved in 41/47 (87%) 6 unsuccessful procedures: –2 went on to bypass –3 received celiac stents –1 lost to follow-up Results PROCEDURE SUCCESS

Symptom Improvement < 30 d –4 point scale 1significant improvement 2partial improvement 3no change 4worsening of symptoms N=41 Results INITIAL SYMPTOM IMPROVEMENT

Primary patency (months): Recurrent blockage of SMA: –7 patients –all had repeat endovascular procedures Secondary patency Results FOLLOW-UP BY ULTRASOUND

Symptom-free 12 mo 24 mo Results SYMPTOMS

Endovascular stenting of complete blockages of the SMA is a safe and effective procedure –minimally-invasive –good technical success rate –easily repeatable –excellent clinical outcomes Conclusions