Document Detail


Rotational atherectomy for treatment of occluded prosthetic grafts.
MedLine Citation:
PMID:  8121169     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Potentially, percutaneous rotational atherectomy (RA) can be used to open occluded prosthetic arterial bypass grafts with less morbidity than surgical catheter thrombectomy. However, RA could damage prosthetic grafts or produce significant distal emboli. To investigate this, acutely thrombosed and chronically occluded prosthetic grafts, harvested from dogs, were placed in an ex vivo perfusion system and recanalization was attempted using the TRAC-Wright rotational atherectomy system. Urokinase (UK) was delivered through the RA catheter in one-half of the procedures. Graft surface thrombogenicity and graft mechanical integrity after successful recanalization were determined and debris released during recanalization was collected. Results were compared to those from grafts opened by catheter thrombectomy. One hundred percent (22/22) of acute prosthetic graft occlusions and 39% (16/41) of chronic prosthetic graft occlusions were opened using RA, similar to results achieved using catheter thrombectomy. In addition, surface thrombogenicity after recanalization of acute graft occlusion with RA was lower than that after catheter thrombectomy (P < 0.05) and infusion of UK improved RA success in chronically occluded grafts (52% vs 25%). Debris generated during RA averaged 15-18 micrograms, equivalent to debris generated during catheter thrombectomy, and graft mechanical integrity was unaffected by recanalization using RA. Thus, rotational atherectomy is a minimally invasive means of safe and effective prosthetic graft recanalization that produces a less thrombogenic graft than thrombectomy.
Authors:
S B Self; D A Coe; S Normann; J M Seeger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of surgical research     Volume:  56     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-04-05     Completed Date:  1994-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  134-40     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Florida College of Medicine, Gainesville 32610-0286.
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MeSH Terms
Descriptor/Qualifier:
Animals
Atherectomy / methods*
Blood Vessel Prosthesis*
Dogs
Graft Occlusion, Vascular / therapy*
Polyethylene Terephthalates
Polytetrafluoroethylene
Rotation
Thrombosis / therapy
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates; 9002-84-0/Polytetrafluoroethylene

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


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