Document Detail


The efficacy of percutaneous transluminal angioplasty in the treatment of infrainguinal vein bypass graft stenosis.
MedLine Citation:
PMID:  12742954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Percutaneous angioplasty would provide a durable alternative to surgical revision in the treatment of infrainguinal vein graft stenosis. DESIGN: Outcome analysis of the results of percutaneous angioplasty of infrainguinal vein graft stenosis. SETTING: Academic vascular surgical practice in a university-affiliated community hospital. PARTICIPANTS: All patients undergoing percutaneous intervention for infrainguinal vein graft stenosis from January 1, 1995, to May 31, 2002, were enrolled in the study. INTERVENTIONS: Lower extremity arterial reconstruction was performed by one of us. Proximal and distal sites of graft placement were identified, as well as the conduit used. Percutaneous angioplasty was performed on grafts by 1 of 4 interventional radiologists. Criteria for intervention and the anatomic location of intervention were noted. Morbidity from percutaneous intervention was also determined. MAIN OUTCOME MEASURES: Success and durability of percutaneous angioplasty were determined by clinical follow-up, duplex surveillance, and arteriography. Failure was defined as duplex ultrasonographic or arteriographic documentation of stenosis of 75% or greater. Kaplan-Meier life table analysis was applied to all grafts in the study. RESULTS: Ninety-four patients with 101 grafts were included in the study. Nearly 35% of angioplasties had failed at 6 months, 53.6% had failed at 12 months, 60.6% had failed at 24 months, and 75.1% had failed at 36 months. Comorbid disease, use of anticoagulant medications, criteria for intervention, or anatomic location of percutaneous intervention did not affect patency. Eight angioplasties (7.9%) were associated with significant complications. CONCLUSIONS: Percutaneous angioplasty does not provide a durable solution to the problem of infrainguinal vein graft stenosis. Because of the high rate of complications, its routine use cannot be advocated.
Authors:
Jason Q Alexander; Steven G Katz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  138     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-13     Completed Date:  2003-06-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-3; discussion 513     Citation Subset:  AIM; IM    
Affiliation:
Division of Vascular Surgery, Department of Surgery, Keck School of Medicine, University of Southern California, Huntington Memorial Hospital, Pasadena, CA 91105, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon*
Female
Graft Occlusion, Vascular / surgery*
Humans
Male
Middle Aged
Treatment Outcome
Vascular Patency

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


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