title: Recanalization of failed autogenous conduit utilizing laser revascularization.
abstract: The traditional approach for the treatment of restenosis of autogenous vein bypass has been revision of bypass with vein patch angioplasty, interposition jump graft, or thrombectomy procedures for those patients with extensive occlusive disease and limb-threatening ischemia. Endovascular intervention traditionally involves angioplasty of the graft; however, vessels with diffuse disease or extensive longitudinal lesions are generally difficult to revascularize utilizing this technique. Surgical revision of a threatened autogenous vein graft may carry a morbidity rate as high as 13.6%. We present a series of cases in which excimer laser atherectomy (LA) was used to recanalize an occluded autogenous saphenous vein bypass. Of the occluded vein bypasses failed angioplasty and were successfully atherectomized with LA measuring lengths of 35 and 30 cm, respectively. The infrainguinal has a 6-month follow-up, while the infragencular has a follow-up of 1 year, with resolution of presenting symptoms.
authors: Department of Surgery, Montefiore Medical Center—North Division, 600 East 233rd Street, Bronx, NY 10466, USA. rchander08820@yahoo.com
authors: Rajiv K
authors: RK
authors: Chander
authors: Parind
authors: P
authors: Oza
authors: Mayank
authors: M
authors: Patel
authors: Nilesh
authors: N
authors: Balar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation; D054018:Lasers, Excimer; D008297:Male; D011859:Radiography; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D017211:Treatment Failure; D058017:Vascular Grafting / Q000009:adverse effects*