Covered stents show lower restenosis and reintervention rates than bare metal stents for chronic mesenteric ischaemia


Vascular surgeons and researchers from the Mayo Clinic in Rochester, USA, and University of Tennessee at Chattanooga joined hands to compare outcomes of mesenteric angioplasty using percutaneous transluminal angioplasty and stenting with iCAST/V12 covered stents (Atrium) or bare metal stents in patients with chronic mesenteric ischaemia. Their findings were released at the 66th Vascular Annual Meeting presented by the Society for Vascular Surgery on 7 June 2012. 

“Mesenteric stenting shows high restenosis and reintervention rates. Covered stents have been shown to lower restenosis rates when used for renal alignment in fenestrated endografts and treatment of failing arteriovenous grafts,” said Gustavo S Oderich, from the Mayo Clinic. “The purpose of this study was to compare outcomes of mesenteric stenting using bare metal or covered balloon expandable stents for treatment of chronic mesenteric ischaemia.”

“We reviewed the clinical data of non-randomised 225 patients (65 male and 160 female; mean age 72±12 years) treated for chronic mesenteric ischaemia (2000–2010). Outcomes were analysed in patients who had primary intervention or reintervention using bare metal stents (164 patients) or covered stents (63 patients). Endpoints were freedom from restenosis, recurrence and reintervention, and primary and secondary patency rates.”

Patients in both groups had similar demographics, cardiovascular risk factors and extent of disease. In terms of early outcomes, there was statistically significant difference between patients treated with bare metal and covered stents for technical success, complications, mortality, morbidity, length of stay and symptom improvement.

Mean follow-up was 29 months. Patients treated by covered stents had less restenosis, recurrences and reinterventions compared to those treated by bare metal stents, both in the primary intervention and in the reintervention groups (p<0.05). Primary patency at two years was significantly higher for covered stents compared to bare metal stents in the primary intervention group (91±6 vs. 60±5; p<0.003).

Oderich concluded that covered stents were associated with less recurrences and reinterventions in patients undergoing primary interventions or reinterventions for chronic mesenteric ischaemia. “Primary patency was significantly higher for covered stents as compared to bare metal stents in the primary intervention group.”