Long Term Outcomes of Endovascular Therapy for Failing Distal Bypass Vein Grafts

Kobayashi, Taira; Hamamoto, Masaki; Okazaki, Takao; Hasegawa, Misa; Takahashi, Shinya

doi:10.1016/j.ejvs.2020.09.021

Cited by 3 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These are comparable to Patel's and Kobayashi's studies. 11,12 Our relatively low primary patency rate in comparison to Carlson and Oostenbrugge studies, 6,7 can be justified by our intensive duplex surveillance program that identifies early graft failure (50% stenosis) requiring EVT or surgical intervention. Thus, a clearly defined clinical followup system and a duplex surveillance program are needed to improve graft patency.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Secondary Interventions to Rescue Threatened Distal Bypasses for Limb Salvage

Soliman

Elsabbagh

Elshimy

et al. 2023

Ain Shams Journal of Surgery

View full text Add to dashboard Cite

Objective: This study is evaluating the effectiveness of salvage interventions to rescue threatened infra-popliteal (IP) bypasses in critical limb ischemia (CLI) patients. Materials and methods:Data of all CLI patients who underwent distal IP bypasses at a single institution between 2016 and 2021 are analysed retrospectively. Patency rates, amputation-free survival, patient survival, and wound healing rates after a 1-year follow-up period are calculated. Comparative analyses of amputation free survival and patient survival rates between non-threatened, threatened and acutely occluded grafts are also done.Results: A total of 121 IP bypasses were performed in 115 patients (84 male; mean age, 74.4±8; hypertension, 84%; diabetes mellitus, 69%). 24% originated from the common femoral artery, 40% from the superficial femoral artery and 36% from the popliteal artery. The most common outflow arteries are the anterior tibial artery (36%) and the posterior tibial artery (33%). Secondary interventions in the form of endovascular and surgical revisions are necessitated in 53 (44%) grafts.At one-year follow-up, primary, assisted-primary, and secondary patency rates are 50%, 78% and 88%, respectively. Amputation-free survival and patient survival rates are 93% and 86%, respectively. Complete wound healing rate is 83%. Amputation-free survival among acutely occluded grafts is significantly worse when compared with threatened and non-threatened grafts (P-value<0.001). Conclusion:Secondary interventions to rescue threatened distal bypasses are successful at maintaining graft patency with amputation-free survival rate comparable to non-threatened grafts. Salvage angioplasty is a viable alternative to surgical revision to rescue limbs with threatened grafts in CLI patients.

show abstract