| Autor: |
Siskin, Gary, Stainken, Brian, Mandell, Valerie, Darling, R., Dowling, Kyran, Herr, Allen, Siskin, G P, Stainken, B F, Mandell, V S, Darling, R C, Dowling, K, Herr, A |
| Zdroj: |
CardioVascular & Interventional Radiology; Sep1999, Vol. 22 Issue 5, p375-380, 6p |
| Abstrakt: |
Purpose: To evaluate the role of metallic stents in treating stenoses involving prosthetic arterial bypass grafts.Methods: Patients undergoing stent placement within a failing prosthetic bypass graft, during a 41-month period, were reviewed for treatment outcome and complications. The indications for stent placement in 15 patients included severe claudication (n = 3), rest pain (n = 9), and minor or major tissue loss (n = 3). Lesions were at the proximal anastomosis (n = 6), the distal anastomosis (n = 3), or within the graft (n = 6).Results: Treatment with metallic stents was successful in all patients. There was one acute stent thrombosis, successfully treated with thrombolytic therapy. Follow-up data are available for a mean duration of 12.3 months. The mean duration of primary patency was 9.4 months with 6- and 12-month primary patency rates of 51.9% and 37.0%, respectively. The mean duration of secondary patency was 12.1 months with 6- and 12-month secondary patency rates of 80.0% and 72.7%, respectively. Two patients with discontinuous runoff and preexisting gangrene required a below-knee amputation. Six patients were revised surgically after stent placement (at a mean of 10.8 months). Three late deaths occurred during follow-up.Conclusion: Given the mortality risks of surgical revision and the reduced life expectancy of this patient population, metallic stent placement represents a viable, short-term treatment option for stenoses within or at the anastomoses of prosthetic grafts. Further evaluation is warranted to compare intragraft stent placement with surgical graft revision. [ABSTRACT FROM AUTHOR] |
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