Beware the Kinking Bypass – a Hidden Cause of Graft Reocclusion

Biemans, Johannes M A; Berg, Jos C. van den; Moll, Frans L.

doi:10.1053/ejvx.2002.0145

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…Vascular grafts have to resist not only loads by blood pressure, there act also mechanical loads from the surrounding. Depending on the location in the body, the vessels are bent and twisted (Dobrin et al 2001;Biemans et al 2002). In kinking tests, the smallest radius of curvature that the graft can withstand without kinking or lumen loss of more than 50% occurs (Bode et al 2015;Bensch et al 2016;Brandt-Wunderlich et al 2016;Kanapathy et al 2016).…”

Section: Kink Diameter Testmentioning

confidence: 99%

Mechanical Testing of Vascular Grafts

Stoiber

Grasl

Moscato

et al. 2020

Tissue-Engineered Vascular Grafts

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Beside other requirements, the mechanical behavior plays an important role in the success of vascular grafts. For the development, quality control, and assessment of vascular grafts, precise and predictive mechanical characterization is essential. Today's technology offers a wide range of mechanical tests for various applications. The selection of the proper test method out of these numerous options is a challenging task, because different scientific questions and issues require different testing methods. In this chapter, an overview and review of important methods with numerous relevant references for the mechanical characterization of vascular grafts is given. In addition, a classification of the testing methods according to the measurement purpose is presented. Special attention is paid to dynamic measurement techniques, which are more close to the target application. Challenges and possibilities of these measurement methods are demonstrated and discussed. This shall form a basis to assess one's own needs and to help at the selection process to find the most suitable testing methods.

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Section: Kink Diameter Testmentioning

confidence: 99%

Mechanical Testing of Vascular Grafts

Stoiber

Grasl

Moscato

et al. 2020

Tissue-Engineered Vascular Grafts

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“…Diagnosis should be made by measuring the ankle brachial index (ABI) in flexion and extension of the knee joint, followed by duplex ultrasound and angiography in two perpendicular projections with the knee in flexion and extension. Treatment of stenotic kinking of the below the knee prosthetic bypass (BKPB) was previously limited to surgical revision with implantation of a new prosthetic graft [ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Five-Year Experience of Interwoven Self-Expanding Stent Implantation in Stenotic Kinking of Below the Knee Prosthetic Bypasses

Salamaga,

Stanišić,

Stępak

et al. 2024

Cardiovasc Intervent Radiol

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Purpose The purpose of this study was to evaluate the 5-year real-world results of Supera stent implantation in below the knee prosthetic bypasses (BKPBs). All the procedures were performed because of a history of recurrent thrombosis of the graft and significant stenotic kinking of the prosthesis during knee flexion. A Supera stent was implanted to prevent the next potential BKPB thrombosis. Materials and Methods Fourteen patients were included in this single-center, retrospective observational cohort study. All patients underwent Supera stent implantation in infrainguinal prosthetic bypass between 2012 and 2017, due to a history of recurrent thrombosis and kinking of the prosthetic bypass. Results Prior to Supera stent implantation procedure, all the patients had more than one episode of acute limb ischemia caused by thrombosis of the BKPB. The median number of BKPB thromboses prior to Supera stent implantation was 3 and ranged from 2 to 6. Technical success was achieved in all cases. Primary patency rates at 12, 24, 36 and 60 months were 71.4%, 57.1%, 57.1% and 14.3%, respectively. Secondary patency rates at 12, 24, 36 and 60 months were 78.6%, 64.3%, 64.3% and 35.7%, respectively. One stent fracture was reported during 60-month follow-up. Major amputation was performed in 6 patients in 5-year follow-up. Conclusion Supera stent in treatment of recurrent thrombosis of BKBP is a safe procedure with acceptable mid-term results. However, larger and comparable prospective studies are needed for broader analysis of this procedure. Graphical Abstract

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