Efficacy of Balloon Angioplasty for Infrainguinal Vein Graft Stenosis.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 23 11 2018
revised: 09 01 2019
accepted: 15 03 2019
pubmed: 15 6 2019
medline: 24 12 2019
entrez: 15 6 2019
Statut: ppublish

Résumé

Vein graft stenosis is a critical complication of lower-limb bypass surgery. For vein graft stenosis, balloon angioplasty has been performed instead of surgical revision in recent years. We therefore investigated the effectiveness of the balloon angioplasty for vein graft stenosis. We conducted a retrospective analysis of prospectively collected data for 115 vein graft stenoses performed via balloon angioplasty from August 2011 to January 2018. The rate of freedom from reintervention after balloon angioplasty was 54.3%, 44.4%, and 38.0% at 1, 2, and 3 years, respectively. The rate of freedom from graft occlusion after balloon angioplasty was 79.9%, 71.9%, and 61.3% at 1, 2, and 3 years, respectively. Predictors of freedom from graft occlusion after balloon angioplasty by a multivariate analysis were a single treated lesion (hazard ratio [HR]: 0.38; 95% confidence interval [CI]: 0.17-0.85; P = 0.0189), balloon angioplasty within 90 days after bypass surgery (HR: 3.59; 95% CI: 1.56-8.07; P = 0.0033), and using a cutting balloon (HR: 0.42; 95% CI: 0.17-0.97; P = 0.0426). The freedom from graft occlusion rate after balloon angioplasty remained relatively high. Furthermore, better results can be expected in single treated lesions and cases of balloon angioplasty occurring 90 days after bypass surgery or in which a cutting balloon was used. Balloon angioplasty for lower-limb bypass graft stenosis was shown to be a useful treatment.

Sections du résumé

BACKGROUND BACKGROUND
Vein graft stenosis is a critical complication of lower-limb bypass surgery. For vein graft stenosis, balloon angioplasty has been performed instead of surgical revision in recent years. We therefore investigated the effectiveness of the balloon angioplasty for vein graft stenosis.
METHODS AND RESULT RESULTS
We conducted a retrospective analysis of prospectively collected data for 115 vein graft stenoses performed via balloon angioplasty from August 2011 to January 2018. The rate of freedom from reintervention after balloon angioplasty was 54.3%, 44.4%, and 38.0% at 1, 2, and 3 years, respectively. The rate of freedom from graft occlusion after balloon angioplasty was 79.9%, 71.9%, and 61.3% at 1, 2, and 3 years, respectively. Predictors of freedom from graft occlusion after balloon angioplasty by a multivariate analysis were a single treated lesion (hazard ratio [HR]: 0.38; 95% confidence interval [CI]: 0.17-0.85; P = 0.0189), balloon angioplasty within 90 days after bypass surgery (HR: 3.59; 95% CI: 1.56-8.07; P = 0.0033), and using a cutting balloon (HR: 0.42; 95% CI: 0.17-0.97; P = 0.0426).
CONCLUSIONS CONCLUSIONS
The freedom from graft occlusion rate after balloon angioplasty remained relatively high. Furthermore, better results can be expected in single treated lesions and cases of balloon angioplasty occurring 90 days after bypass surgery or in which a cutting balloon was used. Balloon angioplasty for lower-limb bypass graft stenosis was shown to be a useful treatment.

Identifiants

pubmed: 31200031
pii: S0890-5096(19)30369-3
doi: 10.1016/j.avsg.2019.03.015
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

364-370

Informations de copyright

Copyright © 2019. Published by Elsevier Inc.

Auteurs

Atsushi Guntani (A)

Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan. Electronic address: aguntani@gmail.com.

Eisuke Kawakubo (E)

Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan.

Shinsuke Mii (S)

Department of Vascular Surgery, Saiseikai Yahata General Hospital, Kitakyushu, Japan.

Daisuke Matsuda (D)

Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.

Kiyoshi Tanaka (K)

Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.

Jin Okazaki (J)

Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.

Yoshimitsu Soga (Y)

Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

Masaru Ishida (M)

Department of Vascular Surgery, Steel Memorial Yawata Hospital, Kitakyushu, Japan.

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