دورية أكاديمية
Open surgical revision provides a more durable repair than endovascular treatment for unfavorable vein graft lesions.
العنوان: | Open surgical revision provides a more durable repair than endovascular treatment for unfavorable vein graft lesions. |
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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.) |
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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 |
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