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Titolo:
IDENTIFICATION OF PREDICTORS FOR LOWER-EXTREMITY VEIN GRAFT STENOSIS
Autore:
GENTILE AT; MILLS JL; GOODEN MA; WESTERBAND A; CUI HY; BERMAN SS; HUNTER GC; HUGHES JD;
Indirizzi:
UNIV ARIZONA,HLTH SCI CTR,ARIZONA CANC CTR,DEPT SURG,DIV VASC SURG,POB 245072 TUCSON AZ 85724 UNIV ARIZONA,HLTH SCI CTR,ARIZONA CANC CTR,DEPT SURG,DIV VASC SURG TUCSON AZ 85724 UNIV ARIZONA,HLTH SCI CTR,ARIZONA CANC CTR,DEPT BIOMETRY TUCSON AZ 85724
Titolo Testata:
The American journal of surgery
fascicolo: 2, volume: 174, anno: 1997,
pagine: 218 - 221
SICI:
0002-9610(1997)174:2<218:IOPFLV>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
DUPLEX SURVEILLANCE; ARTERIAL-DISEASE; AUTOGENOUS VEIN; SAPHENOUS-VEIN; SMOKING; ATHEROSCLEROSIS; PATENCY; BYPASS; POPLITEAL; IMPACT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
A.T. Gentile et al., "IDENTIFICATION OF PREDICTORS FOR LOWER-EXTREMITY VEIN GRAFT STENOSIS", The American journal of surgery, 174(2), 1997, pp. 218-221

Abstract

BACKGROUND: The cause of intrinsic vein graft stenosis, which develops in at least 20% of infrainguinal autogenous bypass grafts during theintermediate follow-up interval, is unknown. We performed standard duplex surveillance of all lower extremity bypass grafts and evaluated the potential of comorbid patient risk factors that might predict development of vein graft flow disturbance or high-grade graft stenosis. METHODS: Patients with at least 6 months of postoperative duplex surveillance were identified through our vascular registry. The association of clinical and hemodynamic profiles of graft performance were comparedwith specific patient risk factors, including demographics, cigarettesmoking, antihypertensive medical therapy, type and quality of conduit, degree of ischemia, bypass run-off, and presence of infection, using stepwise logistic regression analysis. RESULTS: Ninety-three patients (55 male, 38 female; mean age 69) underwent 100 infrainguinal bypasses. Twenty-Six high-grade graft stenoses (>70%) were identified in 26 patients during follow-up (mean 21 months) by graft-flow peak systolicvelocity (PSV) >300 cm/sec on more than one duplex examination, and were electively revised. Graft flow disturbances (180 cm/sec >PSV <300 cm/sec) were identified in an additional 13 grafts (6 regressed, 7 observed). The need for graft revision was associated with an early graftflow disturbance (P = 0.02), or drop in ankle-brachial index >0.15 (P= 0.03), and the use of an alternative conduit in 13 of 100 grafts (P= 0.04). Only smoking was associated with the development of a duplexdetected graft flow disturbance during follow up (P = 0.03). CONCLUSION: Grafts with early flow disturbances warrant close duplex surveillance to identify graft-threatening stenosis. Risk factors that may predict future lower extremity bypass graft stenosis are smoking and the use of alternative bypass conduits. (C) 1997 by Excerpta Medica, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 16:19:04