Annals of vascular surgery
July 14, 2026 · via Europe PMC
Early Peak Systolic Velocity and Trend Variation Predict Stent Patency in Chronic Mesenteric Ischemia and Propose a Post-intervention Surveillance Algorithm.
Sorour AA, Khan A, Bertolino EP, +7 more, Kirksey L.
AI summary — for doctors, generated from the abstract only
In patients with stents placed for chronic gut artery blockage (mesenteric ischemia), both high initial blood flow velocity on ultrasound and rising velocity over time were strong predictors of stent failure, supporting the use of ultrasound surveillance to catch problems early.
What was studied
A single-center retrospective analysis of 179 patients (240 stented vessels: 165 superior mesenteric artery, 75 celiac artery) treated for chronic mesenteric ischemia with stenting between 2003 and 2020, with at least 2 years of follow-up, examining whether early postoperative peak systolic velocity (PSV) on ultrasound and its progression over time predicted loss of stent patency (openness).
Key findings
- Higher early peak systolic velocity (measured within 3 months of stenting) was a strong, independent predictor of stent patency loss, with each 10 cm/s increase in early superior mesenteric artery velocity conferring a 5% higher risk of patency loss.
- Every 10 cm/s rise in superior mesenteric artery peak velocity over time corresponded to a 4-5% increased risk of patency loss; the exact p-value for the initial finding is not reported in the available abstract text, which appears truncated.
- A velocity rise of 100 cm/s or more, or a 50% or greater increase, tripled the risk of stent failure.
- Both elevated early velocity and progressive increases over time were identified as strong, reproducible predictors of mesenteric stent failure, leading the authors to propose a surveillance framework based on these findings.
Clinical relevance
The findings support using routine duplex ultrasound surveillance after mesenteric artery stenting, with specific attention to both the early postoperative velocity reading and how it changes over time, as both are strong, actionable markers for identifying patients at risk of stent failure who may need closer monitoring or earlier intervention.
Who should care
Limitations
Single-center retrospective study design, and the authors themselves describe the proposed surveillance framework as 'hypothesis-generating' rather than definitively validated, meaning it would benefit from prospective testing before widespread clinical implementation.
Both high initial blood flow velocity and rising velocity over time after mesenteric artery stenting strongly predicted stent failure, supporting a structured ultrasound surveillance approach using these markers.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Objective
Stenting of the superior mesenteric artery (SMA) and celiac artery is the more prevalent treatment for symptomatic chronic mesenteric ischemia (CMI). The SVS recommends duplex ultrasound for post-stenting surveillance. This study aimed to determine whether early postoperative peak systolic velocity (PSV) and subsequent PSV progression predict primary patency (PP) loss after SMA stenting.
Methods
Single-center retrospective analysis of 179 patients (240 vessels: 165 SMA, 75 celiac) treated between 2003 and 2020 with ≥2 years of follow-up. Early PSV was defined as duplex velocity within 3 months post-stenting. PSV progression was categorized as <100 cm/s or ≥100 cm/s absolute increase and <50% or ≥50% relative increase from baseline. Cox proportional hazards and time-dependent ROC analyses assessed associations between PSV and PP.
Results
Higher early PSV was a strong independent predictor of PP loss. Each 10 cm/s increase in early SMA-PSV conferred a 5% higher risk of PP loss (HR 1.05; P < 0.001); similar trends were observed in celiac stents (HR 1.06, P 0.064). Progressive PSV increase over time was also predictive: a ≥100 cm/s rise tripled the risk of stent failure (HR 3.26; P 0.001), and a ≥50% rise yielded comparable risk (HR 3.58; P < 0.001). Progressive increase of SMA-PSV by 10 cm/s increased the risk of PP loss by 5% (HR: 1.05; P 0.008). ROC analysis at 24 months showed limited discriminative power for isolated velocity thresholds (AUC 0.66), underscoring the superior predictive value of PSV trends.
Conclusion
Both elevated early PSV and progressive increases over time are strong, reproducible predictors of mesenteric stent failure. Every 10 cm/s rise in SMA PSV corresponds to a 4-5% increased risk of PP loss, while a ≥100 cm/s or ≥50% PSV rise triples failure risk. These findings establish PSV progression as a clinically meaningful marker of restenosis and propose a retrospective, hypothesis-generating surveillance framework.
DOI
10.1016/j.avsg.2026.07.007
PMID
42448031
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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