دورية أكاديمية
أعرض في EDS

Open surgical revision provides a more durable repair than endovascular treatment for unfavorable vein graft lesions.

التفاصيل البيبلوغرافية
العنوان: Open surgical revision provides a more durable repair than endovascular treatment for unfavorable vein graft lesions.
المؤلفون: McCallum JC; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Bensley RP; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Darling JD; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Hamdan AD; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Wyers MC; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Hile C; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Guzman RJ; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass., Schermerhorn ML; Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Mass. Electronic address: mscherme@bidmc.harvard.edu.
المصدر: Journal of vascular surgery [J Vasc Surg] 2016 Jan; Vol. 63 (1), pp. 142-7. Date of Electronic Publication: 2015 Oct 17.
نوع المنشور: Comparative Study; Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008-> : New York, NY : Elsevier
Original Publication: St. Louis, Mo. : Mosby, [c1984-
مواضيع طبية MeSH: Endovascular Procedures*/adverse effects, Graft Occlusion, Vascular/*therapy , Lower Extremity/*blood supply , Peripheral Arterial Disease/*surgery , Vascular Grafting/*adverse effects , Veins/*transplantation, Aged ; Aged, 80 and over ; Amputation, Surgical ; Boston ; Chi-Square Distribution ; Female ; Graft Occlusion, Vascular/diagnosis ; Graft Occlusion, Vascular/etiology ; Graft Occlusion, Vascular/physiopathology ; Graft Occlusion, Vascular/surgery ; Humans ; Kaplan-Meier Estimate ; Limb Salvage ; Male ; Middle Aged ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/physiopathology ; Proportional Hazards Models ; Reoperation ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Failure ; Vascular Patency ; Veins/physiopathology
مستخلص: Objective: Lower extremity bypass grafts that develop stenoses are commonly treated with either open surgical or endovascular revision. Vein graft stenoses with unfavorable lesions (multiple lesions, lesions >2 cm in length, lesions in grafts <3 months old, lesions in grafts <3 mm in diameter) fare worse than those with favorable lesions when treated with endovascular therapy. However, it is not known if unfavorable lesions fare better with surgical revision than with endovascular treatment or than favorable lesions treated with surgery.
Methods: We performed a retrospective review of 175 vein graft revisions performed at a single institution from 2000 to 2010. Characteristics of lesions treated with surgical and endovascular revision were identified. Cox proportional hazard models were used to identify predictors of revision failure (restenosis >75%, revision, or amputation).
Results: Ninety-one failing vein grafts (52%) were treated with surgical revision and 84 with endovascular treatment (48%), with a median follow-up of 30 months. Favorable lesions fared better than unfavorable lesions after endovascular treatment, with 12-month freedom from failure of 59% vs 34% (P < .01), but not after surgical revision (66% vs 62%; P = .90). Unfavorable lesions had better freedom from failure after surgery than endovascular treatment (62% vs 34%; P < .01), and results in favorable lesions were similar (66% vs 59%; P = .57).
Conclusions: For the treatment of failing vein grafts, endovascular therapy appears adequate for favorable lesions and surgical revision is more durable for unfavorable lesions.
(Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
References: J Vasc Surg. 2004 Nov;40(5):916-23. (PMID: 15557905)
J Endovasc Surg. 1999 Feb;6(1):66-72. (PMID: 10088892)
Semin Vasc Surg. 2009 Dec;22(4):261-6. (PMID: 20006807)
J Vasc Surg. 1997 Feb;25(2):211-20; discussion 220-5. (PMID: 9052556)
J Korean Surg Soc. 2012 Nov;83(5):307-15. (PMID: 23166890)
J Vasc Surg. 2007 Dec;46(6):1173-1179. (PMID: 17950564)
J Vasc Surg. 2008 Sep;48(3):613-8. (PMID: 18639428)
J Vasc Surg. 1987 Feb;5(2):256-68. (PMID: 3546739)
Eur J Vasc Endovasc Surg. 2009 Feb;37(2):198-205. (PMID: 19046905)
Ann Vasc Surg. 1998 Mar;12(2):134-7. (PMID: 9514230)
J Vasc Surg. 2014 Apr;59(4):996-1002. (PMID: 24361199)
J Vasc Surg. 2009 Jan;49(1):117-21. (PMID: 19028063)
J Vasc Surg. 2007 Dec;46(6):1167-72; discussion 1172. (PMID: 17950566)
Vasc Endovascular Surg. 2006 Jan-Feb;40(1):11-22. (PMID: 16456601)
Ann Surg. 1981 Jan;193(1):35-42. (PMID: 7458449)
J Vasc Surg. 1999 Jan;29(1):60-70; discussion 70-1. (PMID: 9882790)
J Vasc Surg. 2002 Apr;35(4):773-8. (PMID: 11932678)
J Vasc Surg. 1992 Jan;15(1):130-41; discussion 141-2. (PMID: 1530823)
J Vasc Surg. 1995 Feb;21(2):282-93; discussion 293-5. (PMID: 7853601)
Arch Surg. 1986 Jul;121(7):758-9. (PMID: 2940990)
معلومات مُعتمدة: T32 HL007734 United States HL NHLBI NIH HHS; HL007734 United States HL NHLBI NIH HHS
تواريخ الأحداث: Date Created: 20151021 Date Completed: 20160502 Latest Revision: 20221207
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC4698070
DOI: 10.1016/j.jvs.2015.08.065
PMID: 26483000
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-6809
DOI:10.1016/j.jvs.2015.08.065