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UPA Perpustakaan Universitas Jember

What is the Best Revascularization Strategy for Acute Occlusive Arterial Mesenteric Ischemia: Systematic Review and Meta-analysis

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Purpose Acute mesenteric ischemia (AMI) is a life-
threatening disease that leads to bowel infarction and
death. The optimal management of AMI remains contro-
versial. The present meta-analysis aimed to estimate the
prognostic impact of surgical (SG) versus endovascular or
hybrid intervention (EV) as the first-line treatment for
acute arterial occlusive mesenteric ischemia and to assess
whether endovascular strategy was actually effective in
reducing bowel resection.
Methods MEDLINE, Scopus and the Cochrane Library
databases were searched. There have been no randomized
controlled trials comparing SG versus EV for the treatment
of AMI. We undertook this systematic review and meta-
analysis according to MOOSE (Meta-analysis of Obser-
vational Studies in Epidemiology) guidelines, assessing the
included study quality with the Newcastle–Ottawa scale.
Results Seven studies comparing EV versus SG as first
strategy for the treatment of AMI were selected for the
analyses, reporting of 3020 patients. EV was associated
with a reduced risk of in-hospital mortality (RR 0.68; 95%
CI 0.59–0.79; fixed-effects analysis; p \ 0.0001;
I 2 = 4.9%; s 2 = 0.025). Pooled prevalence of mortality

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