Diagnosis and management of failing lower extremity arterial reconstructions prior to graft occlusion

F. J. Veith, R. K. Weiser, S. K. Gupta, E. Ascer, L. A. Scher, R. H. Samson, S. A. White-Flores, S. Sprayregen

Research output: Contribution to journalArticle

93 Scopus citations

Abstract

In 191 instances, infrainguinal graft occlusion was presumed because of a rethreatened foot, diminished pulses and/or decreased ankle pressure. Routine urgent arteriography revealed 38 instances where the graft was patent (22 vein, 16 PTFE). Ten of these grafts were to the femoral artery, 18 to the popliteal artery and 10 were to infrapopliteal arteries. The deterioration despite a patent graft was due to development of inflow stenosis (15), vein graft lesions (13) or distal disease progression (10). All were treated successfully by percutaneous transluminal angioplasty (30) or simple local operative revisions (8). Cumulative life table patency rates 2 years after reintervention were 89% for failing reconstructions to the femoral artery, 94% for those to the popliteal artery and 89% for infrapopliteal procedures. Comparable rates for limb salvage were 90%, 100%, and 100%, respectively. These findings underscore the importance of urgent angiography in suspected lower extremity graft failure. Defects may be detected before real graft occlusion occurs and appropriate interventional treatment can provide important additional periods of limb salvage.

Original languageEnglish (US)
Pages (from-to)381-384
Number of pages4
JournalJournal of Cardiovascular Surgery
Volume25
Issue number5
StatePublished - Dec 1 1984
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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    Veith, F. J., Weiser, R. K., Gupta, S. K., Ascer, E., Scher, L. A., Samson, R. H., White-Flores, S. A., & Sprayregen, S. (1984). Diagnosis and management of failing lower extremity arterial reconstructions prior to graft occlusion. Journal of Cardiovascular Surgery, 25(5), 381-384.