title: Endovascular stenting for stenoses in surgically reconstructed brachiocephalic bypass grafts: immediate and midterm outcomes.
abstract: OBJECTIVE
  To report the use of endovascular stenting for treatment of patients with symptomatic obstruction of brachiocephalic surgical reconstructions.
  
  
  METHODS
  Twenty-two patients (17 men; mean age 65+/-6 years) with 24 symptomatic obstructions of brachiocephalic Dacron bypass grafts (2 aorto-innominate, 9 subclavian-carotid, and 11 carotid-subclavian) were treated with balloon-expandable stents delivered via a percutaneous brachial access or surgical exposure of the common carotid artery. A distal protection device was utilized in the 9 patients with subclavian-carotid bypass grafts. All patients were followed by clinical and Doppler examinations.
  
  
  RESULTS
  Procedural success was 100%; 1 (4.5%) patient developed transient intraprocedural aphasia owing to intolerance to the distal protection balloon occlusion. All 22 patients reported complete relief of their presenting symptoms. Over a 29-month follow-up, 3 (13.6%) restenoses were found, but none was due to stent compression.
  
  
  CONCLUSIONS
  Stenting for obstructed brachiocephalic reconstructions appears to be a safe, effective, and durable therapeutic strategy.
authors.affiliation: University of Texas Medical Branch, Galveston, USA.
authors.forename: Angelo
authors.initials: A
authors.lastname: Anzuini
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiesa
authors.forename: Krishnamoorthy
authors.initials: K
authors.lastname: Vivekananthan
authors.forename: Barry
authors.initials: B
authors.lastname: Uretsky
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.forename: Alberto
authors.initials: A
authors.lastname: Margonato
authors.forename: Flavio
authors.initials: F
authors.lastname: Airoldi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Rosanio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Augello
authors.forename: Yochai
authors.initials: Y
authors.lastname: Birnbaum
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Magnani
authors.forename: Gloria
authors.initials: G
authors.lastname: Esposito
authors.forename: Germano
authors.initials: G
authors.lastname: Melissano
authors.forename: Marcelo R L
authors.initials: MR
authors.lastname: Moura
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D000800:Angioplasty, Balloon; D001027:Aortography; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome
chemical_list: D011093:Polyethylene Terephthalates