|
KMID : 0371320120830050307
|
|
Journal of the Korean Surgical Society
2012 Volume.83 No. 5 p.307 ~ p.315
|
|
|
Treatment of failing vein grafts in patients who underwent lower extremity arterial bypass
|
|
Park Keun-Myoung
Park Yang-Jin
Yang Shin-Seok
Kim Dong-Ik
Kim Young-Wook
|
|
|
Abstract
|
|
|
Purpose: We attempted to determine risk factors for the development of failing vein graft and optimal treatment in patients with infrainguinal vein grafts.
Methods: We retrospectively reviewed a database of patients who underwent infrainguinal bypass using autogenous vein grafts due to chronic atherosclerotic arterial occlusive disease of lower extremity (LE) at a single institute between September 2003 and December 2011. After reviewing demographic, clinical, and angiographic features of the patients with failing grafts, we analyzed those variables to determine risk factors for the development of failing grafts. To determine an optimal treatment for the failing vein grafts, we compared results of open surgical repair (OSR), endovascular treatment (EVT) and conservative treatment.
Results: Two hundred and fifty-eight LE arterial bypasses using autogenous vein grafts in 242 patients were included in this study. During the follow-up period of 39 ± 25 months (range, 1 to 89 months), we found 166 (64%) patent grafts with no restenosis, 41 (15.9%) failing grafts, 39 (15.1%) graft occlusions, and 12 (4.7%) grafts lost in follow-up. In risk factor analysis for the development of a failing graft, no independent risk factors were identified. After 50 treatments of the 41 failing grafts (24 OSR, 18 EVT, 8 conservative management), graft occlusion was significantly more common in conservative treatment group and severe (>75%) restenosis was significantly more common following EVT than OSR (P = 0.001). Reintervention-free graft patency was also superior in the OSR group to that of the EVT group (87% vs. 42%, P = 0.015).
Conclusion: OSR of failing grafts has better outcomes than EVT or conservative management in treating failing grafts.
|
|
|
KEYWORD
|
|
|
Lower extremity, Bypass, Failing graft, Stenosis, Graft occlusion
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|