Landry GJ, et al. - The researchers sought to determine the epidemiology, treatments, and outcomes of acute symptomatic non-atherosclerotic mesenteric vascular disease. In this study, patients with embolism(EM), dissection(DI), and aneurysm(AN) differed in terms of age, anatomic distribution and method of treatment. Long-term survival was significantly influenced by the etiology.

Methods

• Over a six year period, researchers reviewed the subjects.
• For this study, embolism(EM), dissection(DI), and aneurysm(AN) were the included categories.
• Comparison of presentation, demographics, treatment and outcomes was performed.

Results

• Researchers identified 46 patients (EM:20, AN:15, DI:11).
• The categories varied in terms of age at presentation (EM: 66.3, AN 62.4, DI 54.6, p < 0.05).
• Based on findings, EM more frequently affected the superior mesenteric artery (EM80%, AN20%, DI45%, p=0.002), DI hepatic artery (EM20%, AN13%, DI55%, p < 0.05), and AN mesenteric branches (EM5%, AN47%, DI0%; p=0.001).
• History of arrhythmia (EM40%, AN7%, DI0%, p, 0.05) and diarrhea (EM30%, AN7%, DI0%, p<0.05) were more frequent with EM.
• Surgical treatment was most commonly performed in EM (EM85%, AN33%, DI9%, p < 0.001), endovascular in AN (EM5%, AN40%, DI 9%, p < 0.02), and conservative in DI (EM15%, AN 33%, DI82%, p < 0.05).
• They noticed that in hospital mortality was infrequent (EM10%, AN7%, DI0%, p=ns).
• Mean hospital length of stay varied in accordance to the mechanism (EM13.6days, AN9.2, DI2.3, p=0.005).
• Median follow up of 61 months was peformed.
• For emboli, survival at 1, 3 and 5 years, was 75%, 70% and 59%, for aneurysms 93%, 86%, and 77%, and for dissections 100% at all time points (p=0.043 log rank).