Long-term outcome of revised lower-extremity bypass grafts

Abstract

Excellent assisted primary patency and limb-salvage rates can be achieved for as long as 10 years in LEVGs that require revision, with only a 7% drop in overall patency and limb-salvage rates between the fifth and 10th years. Although most revisions were required within the first year, 34% were performed between the first year and the fifth year, and 11% after 5 years. These data support the growing body of evidence that favors an aggressive regimen of duplex scanning surveillance of LEVGs for the life of the graft. Revised grafts have excellent patency through 10 years.

The long-term experience of living with peripheral arterial disease and the recovery following revascularisation: A qualitative study

“…Similar results have also been described in patients having coronary artery disease who were interviewed before and after a coronary bypass; the expected benefits were often unrealistic and at odds with the documented evidence of the benefit of this procedure (Lindsay et al, 2000). The documented evidence regarding the outcome after revascularization has shown a decreasing long-term functional status, and many patients require continued and repeated treatments for the rest of their lives (Nicoloff et al, 1998;Landry et al, 2002, Wann-Hansson et al, 2005 The findings in the present study confirm that vascular interventions should be considered palliative and that patients have to learn to revise their expectations over time and be realistic about possible benefits. Accurate preoperative information is needed regarding the risks and benefits of vascular intervention and underlying atherosclerosis.…”

Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: An intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy

“…70,71 We have discussed this issue elsewhere 37 and point out that such an approach was not regarded as standard of care in the UK at the time the trial was designed. In fact, even today, although some form of graft surveillance seems intuitively beneficial, the only RCT to examine this controversial area did not show any clinical or cost-benefit from routine duplex-based surveillance.…”

Infrainguinal vein graft stenosis: Cutting balloon angioplasty as the first-line treatment of choice

“…However, infrainguinal vein grafts develop stenoses that threaten their patency in up to 20% of the cases. [1][2][3] The traditional treatment for a vein bypass graft stenosis is open surgical revision, and these reconstructions produce reasonable long-term patency rates. 1,[4][5][6] In the endovascular era, there are competing options for the treatment of hemodynamically significant infrainguinal vein bypass graft stenosis that require comparison with open surgical revision.…”