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Titolo:
CLINICAL-RESULTS OF COMMON STRATEGIES USED TO REVISE INFRAINGUINAL VEIN GRAFTS
Autore:
SULLIVAN TR; WELCH HJ; IAFRATI MD; MACKEY WC; ODONNELL TF;
Indirizzi:
TUFTS UNIV NEW ENGLAND MED CTR,DEPT SURG,VASC DIV,750 WASHINGTON ST,BOX 259 BOSTON MA 02111 TUFTS UNIV NEW ENGLAND MED CTR,DEPT SURG,VASC DIV BOSTON MA 02111
Titolo Testata:
Journal of vascular surgery
fascicolo: 6, volume: 24, anno: 1996,
pagine: 909 - 917
SICI:
0741-5214(1996)24:6<909:COCSUT>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERIAL BYPASS; DURABILITY; STENOSIS; FAILURE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
16
Recensione:
Indirizzi per estratti:
Citazione:
T.R. Sullivan et al., "CLINICAL-RESULTS OF COMMON STRATEGIES USED TO REVISE INFRAINGUINAL VEIN GRAFTS", Journal of vascular surgery, 24(6), 1996, pp. 909-917

Abstract

Purpose: Patients who have failing infrainguinal bypass grafts or faded grafts reopened with lytic therapy represent a group at high risk of subsequent failure. Previous studies suggest that vein patch angioplasty and jump grafting may be less durable than interposition graftingas a method of correcting graft lesions. Our objective was to assess the value of various technical strategies grafts and to assess how these variables might affect cumulative graft patency (CGP) rates. Methods: We retrospectively reviewed the clinical course, anatomic sites of revision, and type of revision performed on 67 grafts in 58 patients who underwent at least one revision from 1991 to 1995. Results were assessed with regression analysis and Kaplan-Meier estimates of CGP rates(p <0.05 was considered significant). Results: Sixty-seven vein grafts underwent revision of 112 anatomical sites in 95 operations. Forty-nine of 67 grafts were single-segment greater saphenous vein grafts and18 were composite (>1 segment) grafts, with an overall 5-year CGP rate of 72%. No difference was observed between the 4-year CGP rate in grafts with hemodynamically significant distal anastomotic stenoses repaired primarily with jump grafts (n=20, 71% CGP rate) and those with stenoses found only in the graft body (n=41, 89% CGP rate). Vein patch angioplasty was used primarily, but not exclusively, for focal graft body stenoses (n=35), whereas interposition grafts (n=11) were reserved for more diffuse strictures; no significant difference in 3-year CGP rates was observed (94% and 73%, respectively). Conclusion: Using an appropriate revision strategy that favors vein patch angioplasty for graft body lesions and jump grafts for distal anastomotic lesions, acceptable assisted patency rates can be achieved in grafts that are at riskfor repeated failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/10/20 alle ore 19:30:29