Percutaneous transluminal angioplasty of infrainguinal vein graft stenosis is not a negative predictor for long-term patency.
BACKGROUND
To investigate whether maintenance percutaneous transluminal angioplasty (PTA) for significant stenosis after infrainguinal bypass grafting affects long-term patency of the bypass grafts in comparison to those not needing intervention.


METHODS
The cohort includes 141 consecutive patients with 157 infrainguinal vein grafts performed from January 1996 to December 2005. Grafts occluded within three months after operation were excluded. Revascularisations needing maintenance PTA for significant stenoses of graft or adjacent in- or outflow vessels (intervention group, n = 39) were compared to those not needing intervention during follow up (non-intervention group, n = 118). Primary end point was bypass occlusion. Secondary end points were major amputation or death. Long-term patency in the intervention and non-intervention groups was estimated using Kaplan-Meier curves and compared using the Tarone-Ware test.


RESULTS
In the intervention group, primary assisted patency rate after 36 and 60 months was 94.1 % and 89.4 %, respectively, whereas in the non-intervention group patency rate was 92.5 % and 91.0 %, respectively (p = 0.644). Comparing the intervention group to the non-intervention group, 1 versus 2 major amputations (p = 0.642) and 14 versus 40 deaths (p = 0.233) occurred.


CONCLUSIONS
Occurrence of graft stenosis did not decrease long-term patency rate when treated by PTA in comparison to grafts not needing maintenance PTA.
Vascular and Thoracic Unit, Department of Surgery, Kantonsspital Graubünden, Chur, Switzerland.
Andrea G
AG
Prevost
Georg
G
Heller
Manfred
M
Odermatt
Markus
M
Furrer
D000368:Aged; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects* / Q000401:mortality; D014654:Vascular Patency; D014680:Veins / Q000503:physiopathology / Q000637:transplantation*
PTA; angioplasty; balloon; stenosis; vein bypass