Scholarlink

<p>This prospective multinational substudy of the AMESI project provides critical insights into managing acute SMA occlusion. By comparing endovascular versus surgical revascularization, the authors demonstrate that baseline illness severity, reflected by elevated lactate levels and mechanical ventilation requirements, dominates prognostic outcomes, with adjusted analyses confirming no independent mortality effect from treatment modality (surgery OR 1.59, 95% CI 0.57–4.37). Notably, unadjusted mortality rates varied substantially (endovascular-effective: 2.9% vs. surgical: 45.8%), primarily attributable to patient selection bias toward higher disease severity in the surgical cohort. The inability to identify reliable thresholds for endovascular efficacy underscores the necessity of individualized decision-making based on etiology and physiological status, challenging time-based intervention paradigms.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Refining patient stratification and treatment decision-making in acute SMA occlusion

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月14日

查看全文
  • Yingjian Ye,
  • Yan Hu,
  • Xianqun Ji,
  • Junyan Zhang,
  • Hui Xu,
  • Peng An

摘要

This prospective multinational substudy of the AMESI project provides critical insights into managing acute SMA occlusion. By comparing endovascular versus surgical revascularization, the authors demonstrate that baseline illness severity, reflected by elevated lactate levels and mechanical ventilation requirements, dominates prognostic outcomes, with adjusted analyses confirming no independent mortality effect from treatment modality (surgery OR 1.59, 95% CI 0.57–4.37). Notably, unadjusted mortality rates varied substantially (endovascular-effective: 2.9% vs. surgical: 45.8%), primarily attributable to patient selection bias toward higher disease severity in the surgical cohort. The inability to identify reliable thresholds for endovascular efficacy underscores the necessity of individualized decision-making based on etiology and physiological status, challenging time-based intervention paradigms.