AB168. SOH25_AB_037. Open vs. endovascular management of acute mesenteric ischemia—a systematic review
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AB168. SOH25_AB_037. Open vs. endovascular management of acute mesenteric ischemia—a systematic review

Liam Costello1, Michael Flanagan2, Conor Toale1, Dara Kavanagh1

1Department of Surgery, Tallaght University Hospital, Dublin, Ireland; 2Department of Surgery, St. James’ Hospital, Dublin, Ireland

Background: Acute mesenteric ischaemia (AMI) is increasingly being managed using endovascular or hybrid techniques. A prior systematic review, published in 2019, suggested that endovascular management may be associated with reduced mortality rates and requirement for bowel resection when compared to open surgery. This updated systematic review aims to compare outcomes of open vs. endovascular management of AMI.

Methods: This review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines using three databases; EMBASE, OVID Medline and Web of Science were searched. Original articles comparing mortality rates for patients with AMI managed using endovascular compared to open surgical approaches were sought.

Results: A total of 37 studies were included, with a total of 20,910 patients. Twelve studies were retrospective comparative reviews comparing both endovascular and open surgical management. The 30-day mortality ranged from 21–81% for open surgery and 9.5–53.8% for an endovascular approach.

Conclusions: Studies suggest that endovascular management may be associated with reduced mortality, though the lack of prospective data comparing approaches, and the heterogenous nature of AMI presentation limits the ability to recommend an up-front endovascular approach for all patients.

Keywords: Endovascular; intestinal ischaemia; open surgery; mesenteric ischaemia; minimally invasive

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab168
Cite this abstract as: Costello L, Flanagan M, Toale C, Kavanagh D. AB168. SOH25_AB_037. Open vs. endovascular management of acute mesenteric ischemia—a systematic review. Mesentery Peritoneum 2025;9:AB168.

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