Document Detail

Endovascular treatment of an occluded axillofemoral bypass graft.
MedLine Citation:
PMID:  15920998     Owner:  NLM     Status:  MEDLINE    
Unsuspected subclavian or axillary disease may cause failure of axillofemoral bypass grafts. A 52-year-old woman who underwent left axillofemoral bypass grafting 5 years ago presented with 24 h of left foot pain. Routine duplex ultrasonography 2 months previously demonstrated velocities throughout the graft > 80 cm/s. Emergent angiography revealed thrombotic occlusion of the axillofemoral bypass graft. Both rheolytic thrombectomy and pulse spray thrombolysis using tissue plasminogen activator were used to restore graft patency. Arterial pressure waveform and pressure remained damped throughout the graft; a 50 mmHg gradient was found from the descending thoracic aorta to the mid-left subclavian artery. Angiography revealed a 70% diameter stenosis at the origin of the left subclavian artery. Following balloon angioplasty and stent placement, the pressure gradient was eliminated. In conclusion, careful evaluation of arterial inflow to bypass grafts is critical for ensuring long-term graft patency.
David P Slovut; J Michael Bacharach
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  10     ISSN:  1358-863X     ISO Abbreviation:  Vasc Med     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-05-30     Completed Date:  2005-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  33-6     Citation Subset:  IM    
Department of Cardiology, St Mary's/Duluth Clinic Heart Center, Duluth, Minnesota, USA.
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MeSH Terms
Angiography, Digital Subtraction
Angioplasty, Balloon*
Axillary Artery / surgery
Constriction, Pathologic
Femoral Artery / surgery
Graft Occlusion, Vascular / radiography,  therapy*
Middle Aged
Subclavian Artery / pathology
Vascular Patency
Vascular Surgical Procedures

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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