[Management of anastomotic stenosis after lower extremity bypass surgery with cutting balloon angioplasty].
OBJECTIVE
Conventional balloon angioplasty of anastomotic stenosis following bypass surgery is insufficient at mid- and long-term. However, short-term results with cutting balloon angioplasty (CBA) are satisfactory. The purpose of this study is to determine the long-term results using this technique. Materials and methods. Between January 2002 and January 2006, all patients with anastomotic stenosis more than one month after bypass surgery, shorter than 2 cm and>50%, were referred without randomisation to CBA.


RESULTS
A total of 19 patients with mean age of 63.5 years (55-82 years), 14 males and 5 females, were included. Twenty stenoses (femoral n=15, popliteal n=4 and calf n=1) managed with CBA affected 17 infrainguinal and 2 suprainguinal bypasses. One patient had anastomotic stenoses at both extremities. The rate of technical success aws 100%. Mean follow-up was 32 months (12-42). Three deaths occurred during follow-up. One patient presented with restenosis at 3 months, successfully treated with repeat CBA. No thrombosis or infection was observed.


CONCLUSIONS
The results with CBA appear persistent and compete favorably with results from surgical repair. A randomized trial would be necessary to confirm these results.
Kobeiter
H
H
Service d'Imagerie médicale, CHU Henri Mondor, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil. hicham.kobeiter@hmn.aphp.fr
Jourdan
G
G
Deux
Jf
J
Rahmouni
A
A
Lapeyre
M
M
Luciani
A
A
You
K
K
Becquemin
Jp
J
Desgranges
P
P
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods*; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*