title: Distal percutaneous transluminal angioplasty through infrainguinal bypass grafts.
abstract: OBJECTIVE
  to evaluate the results of transluminal angioplasty (PTA) performed through infrainguinal bypass grafts for stenotic or occlusive lesions at the distal anastomosis and/or in the runoff arteries.
  
  
  METHODS
  retrospective clinical study.
  
  
  METHODS
  forty-one patients underwent 57 procedures at the distal anastomosis (n=13), in the runoff arteries (n=32) or at both locations (n=12) at a median of 9.6 months (range, 2-76 months) after infrainguinal bypass grafting. Nineteen procedures were on the popliteal artery, the rest on the crural arteries. Eleven procedures related to occlusions less than 5 cm in length.
  
  
  RESULTS
  technical success was achieved in 91%. Primary and primary assisted graft patency rates at 3 years were 32% and 53%, respectively. There were no significant differences in patency rates with regard to the graft material, the type of lesion, the level of PTA, the status of runoff and the use of thrombolysis before PTA. No patients underwent amputation as a direct consequence of failed PTA or graft occlusion. One patient underwent acute surgical intervention due to graft occlusion at the time of attempted PTA.
  
  
  CONCLUSIONS
  the results of PTA at the distal anastomosis and/or in the runoff arteries in limbs with infrainguinal bypass seemed to be inferior to the results of surgical revisions reported in literature. However, as failed PTA did not jeopardise vein-patch angioplasty or jump grafting, it is a reasonable alternative to surgical intervention in selected cases.
authors.affiliation: Department of Radiology, University Hospital, Uppsala, Sweden.
authors.forename: A-M
authors.initials: AM
authors.lastname: Löfberg
authors.forename: S
authors.initials: S
authors.lastname: Karacagil
authors.forename: C
authors.initials: C
authors.lastname: Ljungman
authors.forename: R
authors.initials: R
authors.lastname: Nyman
authors.forename: A
authors.initials: A
authors.lastname: Tulga Ulus
authors.forename: A
authors.initials: A
authors.lastname: Boström
authors.forename: G
authors.initials: G
authors.lastname: Ostholm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome