TP5.2.11 Intervention for mesenteric arterial insufficiency in octogenarians

Mesenteric ischaemia is associated with significant morbidity and mortality. The poor prognosis associated with mesenteric ischaemia may prejudice decision-making, particularly for an older patient group. We have explored outcomes following intervention for mesenteric ischaemia in patients aged over 80-years old. Methods This was a retrospective analysis of a database of intervention for mesenteric ischaemia from 2010 to 2020 from a regional vascular unit covering two Health Boards in Scotland. Patients aged 80-years and over were identified and patterns of intervention and outcome described. Results There were 23 procedures performed – there were 17 patients aged 80-years or over. There were 8 patients with acute presentations, 6 had isolated superior mesenteric artery occlusion and thromboembolectomy was the most common procedure (n = 4). Laparotomy was performed in all cases and bowel resection required in 3. At 30-days 4 patients had died, but patients who survived the index admission were still alive at 1-year and symptom free. Elective was performed on 9 patients. An endovascular approach was favoured (n = 7) with the superior mesenteric artery the preferred target. At 30-days 2 had died, but at 1-year there had only been 1 further death. Three patients experienced recurrent symptoms. The remaining patients were symptom free. Conclusion It is appropriate to consider mesenteric intervention for older patients with both acute and chronic mesenteric ischaemia. Meaningful survival can be achieved with good relief of symptoms and return to meaningful quality of life.