| Balloon angioplasty as the primary treatment for failing infra-inguinal vein grafts. | |
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MedLine Citation:
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PMID: 19046905 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We sought to evaluate the role of balloon angioplasty as the primary modality in the management of vein graft stenoses. METHODS: Patients who underwent infrainguinal vein graft bypass from January 2002 to December 2007 were enrolled into a surveillance program. Grafts which developed critical stenoses were identified and underwent urgent angiography with a view to angioplasty of the stenotic lesion. Lesions which were deemed unsuitable for angioplasty underwent urgent surgical repair. RESULTS: Four hundred and eleven grafts were followed up for a median of 19 months (range: 2-61). Ninety-six grafts (22.6%) developed critical stenosis. Twelve grafts occluded prior to repair and one was not intervened upon electively. Eight grafts underwent primary surgical repair. Seventy-six grafts underwent 99 endovascular procedures. Technical success was achieved in 60 grafts (78.9%). Of the grafts in which technical success had not been achieved, eight underwent repeat angioplasty and three were surgically repaired. Twenty-four grafts underwent repeat angioplasty for re-stenosis with a technical success rate of 71%. No difference was observed in graft patency (P=0.08) or amputation rates (P=0.32) between the grafts requiring intervention to maintain patency, and grafts which did not. Smoking [OR: 2.61 (95% CI: 1.51-4.53), (P=0.006)], diabetes [OR: 2.55 (95% CI: 1.49-4.35), (P=0.006)], renal failure [OR: 1.89 (95% CI: 1.19-3.38), (P=0.040)] and recurrent stenosis [OR: 3.22 (95% CI: 1.63-4.69), (P<0.001)] were risk factors for graft occlusion. CONCLUSIONS: Balloon angioplasty of failing infrainguinal vein bypass grafts is safe and can be performed with an acceptable medium term patency rate, albeit with a significant risk of re-stenosis which can be successfully treated in most patients using repeat endovascular intervention. |
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Authors:
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R Mofidi; M Flett; J Nagy; R Ross; G D Griffiths; S Chakraverty; P A Stonebridge |
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Publication Detail:
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Type: Journal Article Date: 2008-11-28 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 37 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-27 Completed Date: 2009-02-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 198-205 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery and Radiology, Ninewells Hospital, Dundee, United Kingdom. rmofidi@doctors.net.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Amputation Angiography, Digital Subtraction Angioplasty, Balloon* Constriction, Pathologic Diabetes Complications / etiology, therapy Female Graft Occlusion, Vascular / etiology, pathology, surgery, therapy* Humans Kidney Failure / complications Male Middle Aged Odds Ratio Recurrence Reoperation Risk Assessment Risk Factors Saphenous Vein / transplantation* Smoking / adverse effects Time Factors Treatment Outcome Ultrasonography, Doppler, Duplex Vascular Patency |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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