Endovascular treatment of an occluded axillofemoral bypass graft

David P. Slovut, J. Michael Bacharach

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Unsuspected subclavian or axillary disease may cause failure of axillofemoral bypass grafts. A 52-year-old woman who underwent left axillofemoral bypass grafting 5 years ago presented with 24 h of left foot pain. Routine duplex ultrasonography 2 months previously demonstrated velocities throughout the graft >80 cm/s. Emergent angiography revealed thrombotic occlusion of the axillofemoral bypass graft. Both rheolytic thrombectomy and pulse spray thrombolysis using tissue plasminogen activator were used to restore graft patency. Arterial pressure waveform and pressure remained damped throughout the graft; a 50 mmHg gradient was found from the descending thoracic aorta to the mid-left subclavian artery. Angiography revealed a 70% diameter stenosis at the origin of the left subclavian artery. Following balloon angioplasty and stent placement, the pressure gradient was eliminated. In conclusion, careful evaluation of arterial inflow to bypass grafts is critical for ensuring long-term graft patency.

Original languageEnglish (US)
Pages (from-to)33-36
Number of pages4
JournalVascular Medicine
Volume10
Issue number1
DOIs
StatePublished - 2005
Externally publishedYes

Fingerprint

Transplants
Subclavian Artery
Thoracic Aorta
Therapeutics
Angiography
Pressure
Thrombectomy
Balloon Angioplasty
Tissue Plasminogen Activator
Stents
Pulse
Foot
Ultrasonography
Arterial Pressure
Pathologic Constriction
Pain

Keywords

  • Axillofemoral bypass graft
  • Extra-anatomic bypass graft
  • Stent
  • Subclavian artery stenosis
  • Thrombectomy
  • Thrombolysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Endovascular treatment of an occluded axillofemoral bypass graft. / Slovut, David P.; Bacharach, J. Michael.

In: Vascular Medicine, Vol. 10, No. 1, 2005, p. 33-36.

Research output: Contribution to journalArticle

Slovut, David P. ; Bacharach, J. Michael. / Endovascular treatment of an occluded axillofemoral bypass graft. In: Vascular Medicine. 2005 ; Vol. 10, No. 1. pp. 33-36.
@article{818b39fdf9354f48ac4629bae54ebe8e,
title = "Endovascular treatment of an occluded axillofemoral bypass graft",
abstract = "Unsuspected subclavian or axillary disease may cause failure of axillofemoral bypass grafts. A 52-year-old woman who underwent left axillofemoral bypass grafting 5 years ago presented with 24 h of left foot pain. Routine duplex ultrasonography 2 months previously demonstrated velocities throughout the graft >80 cm/s. Emergent angiography revealed thrombotic occlusion of the axillofemoral bypass graft. Both rheolytic thrombectomy and pulse spray thrombolysis using tissue plasminogen activator were used to restore graft patency. Arterial pressure waveform and pressure remained damped throughout the graft; a 50 mmHg gradient was found from the descending thoracic aorta to the mid-left subclavian artery. Angiography revealed a 70{\%} diameter stenosis at the origin of the left subclavian artery. Following balloon angioplasty and stent placement, the pressure gradient was eliminated. In conclusion, careful evaluation of arterial inflow to bypass grafts is critical for ensuring long-term graft patency.",
keywords = "Axillofemoral bypass graft, Extra-anatomic bypass graft, Stent, Subclavian artery stenosis, Thrombectomy, Thrombolysis",
author = "Slovut, {David P.} and Bacharach, {J. Michael}",
year = "2005",
doi = "10.1191/1358863x05vm586cr",
language = "English (US)",
volume = "10",
pages = "33--36",
journal = "Vascular Medicine (United Kingdom)",
issn = "1358-863X",
publisher = "SAGE Publications Ltd",
number = "1",

}

TY - JOUR

T1 - Endovascular treatment of an occluded axillofemoral bypass graft

AU - Slovut, David P.

AU - Bacharach, J. Michael

PY - 2005

Y1 - 2005

N2 - Unsuspected subclavian or axillary disease may cause failure of axillofemoral bypass grafts. A 52-year-old woman who underwent left axillofemoral bypass grafting 5 years ago presented with 24 h of left foot pain. Routine duplex ultrasonography 2 months previously demonstrated velocities throughout the graft >80 cm/s. Emergent angiography revealed thrombotic occlusion of the axillofemoral bypass graft. Both rheolytic thrombectomy and pulse spray thrombolysis using tissue plasminogen activator were used to restore graft patency. Arterial pressure waveform and pressure remained damped throughout the graft; a 50 mmHg gradient was found from the descending thoracic aorta to the mid-left subclavian artery. Angiography revealed a 70% diameter stenosis at the origin of the left subclavian artery. Following balloon angioplasty and stent placement, the pressure gradient was eliminated. In conclusion, careful evaluation of arterial inflow to bypass grafts is critical for ensuring long-term graft patency.

AB - Unsuspected subclavian or axillary disease may cause failure of axillofemoral bypass grafts. A 52-year-old woman who underwent left axillofemoral bypass grafting 5 years ago presented with 24 h of left foot pain. Routine duplex ultrasonography 2 months previously demonstrated velocities throughout the graft >80 cm/s. Emergent angiography revealed thrombotic occlusion of the axillofemoral bypass graft. Both rheolytic thrombectomy and pulse spray thrombolysis using tissue plasminogen activator were used to restore graft patency. Arterial pressure waveform and pressure remained damped throughout the graft; a 50 mmHg gradient was found from the descending thoracic aorta to the mid-left subclavian artery. Angiography revealed a 70% diameter stenosis at the origin of the left subclavian artery. Following balloon angioplasty and stent placement, the pressure gradient was eliminated. In conclusion, careful evaluation of arterial inflow to bypass grafts is critical for ensuring long-term graft patency.

KW - Axillofemoral bypass graft

KW - Extra-anatomic bypass graft

KW - Stent

KW - Subclavian artery stenosis

KW - Thrombectomy

KW - Thrombolysis

UR - http://www.scopus.com/inward/record.url?scp=18744387475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=18744387475&partnerID=8YFLogxK

U2 - 10.1191/1358863x05vm586cr

DO - 10.1191/1358863x05vm586cr

M3 - Article

C2 - 15920998

AN - SCOPUS:18744387475

VL - 10

SP - 33

EP - 36

JO - Vascular Medicine (United Kingdom)

JF - Vascular Medicine (United Kingdom)

SN - 1358-863X

IS - 1

ER -