Adult ; Female ; Graft Occlusion, Vascular ; Humans ; Stents ; Takayasu Arteritis ; surgery

Coronary Artery Disease ; diagnosis ; etiology ; Graft Occlusion, Vascular ; diagnosis ; etiology ; Heart Transplantation ; adverse effects ; Humans

Arteriosclerosis Obliterans ; surgery ; Graft Occlusion, Vascular ; therapy ; Humans ; Lower Extremity ; blood supply ; Stents

Primary stenting in femoropopliteal lesions of intermediate length has recently shown favorable outcomes. However, stent fractures are a concern after bare metal stent implantation. The incidence of stent fracture varies widely (ranging from 2% to 65%) depending on factors such as the treated lesions or stent type and may potentially lead to various complications. We reported a case of stent fracture with complete dislocation combined with recurrent in-stent reocclusion and aneurysm formation in a patient with occlusive disease of the femoropopliteal artery, which was successfully treated with self-expandable endovascular stent graft.
Aneurysm* ; Aneurysm, False ; Arteries* ; Blood Vessel Prosthesis ; Dislocations ; Graft Occlusion, Vascular ; Humans ; Incidence ; Stents*

Gene Expression ; Graft Occlusion, Vascular ; prevention & control ; Humans ; Liver ; blood supply ; Stents ; Vascular Endothelial Growth Factor A ; genetics ; metabolism

Appropriate reoperation of the lower extremity artery may be required because of graft stenosis, occlusion, and infection. For high-risk patients who have no autogeneic vein available or who are not suitable for open reoperation, endoluminal plasty may be an alternative. The options of treatment for abdominal aortic aneurysm include traditional procedures and endovascular aneurysm repair (EVAR). The reintervention rate is higher in EVAR than in traditional procedures. The options of treatment for recurrent carotid artery stenosis remain controversial. The advantages and disadvantages of carotid endarterectomy (CEA) and carotid artery stent (CAS) should be compared under comparable clinical situations.
Aortic Aneurysm, Abdominal ; surgery ; Carotid Stenosis ; surgery ; Graft Occlusion, Vascular ; surgery ; Humans ; Lower Extremity ; blood supply ; Reoperation ; Vascular Diseases ; surgery ; Vascular Surgical Procedures ; methods

PURPOSE: To analyze the long-term results of above-the-knee femoro-popliteal bypass (ATKFPB) with vein grafts compared with polytetrafluoroethylene (PTFE) grafts. METHODS: A database of patients with chronic atherosclerotic occlusive disease who underwent ATKFPB was retrospectively reviewed. Characteristics of patient and arterial lesion, and follow-up results were compared between vein grafts and PTFE grafts. Graft patency was determined by periodic examinations of duplex ultrasonography or CT angiograms. Graft patency and limb salvage rates were calculated using the Kaplan-Meier method. RESULTS: In total, 253 ATKFPBs (107 vein grafts; 146 PTFE grafts; critical limb ischemia, 32%) were performed on 228 patients (mean age, 68.5 years; male, 87.7%). No significant differences were observed between the two groups with respect to demographic characteristics, characteristics of arterial lesions, or distal runoff score. During the mean follow-up period of 41 months (range, 1-122 months), 14.5% patients died, and 94% of all limbs were available for follow-up. The primary patency rates were not significantly different between the two groups at 10 years after treatment (75% vs. 42%, P = 0.330). However, the primary-assisted patency rates (88% vs. 42%, P = 0.003) and secondary patency rates (91% vs. 49%, P = 0.013) were significantly higher in the vein grafts compared with the PTFE grafts. Graft occlusion developed more often in the PTFE grafts (5.6% vs. 20.5%, P = 0.001). When graft occlusion occurred, acute limb ischemia was significantly more frequent in the PTFE grafts than in the vein grafts (0% vs. 53%, P = 0.027). CONCLUSION: After ATKFPB, autologous vein grafts showed significantly better long-term results compared with PTFE grafts.
Extremities ; Follow-Up Studies ; Graft Occlusion, Vascular ; Humans ; Ischemia ; Limb Salvage ; Male ; Polytetrafluoroethylene* ; Retrospective Studies ; Transplants* ; Ultrasonography ; Veins*

BACKGROUND: Salvaging prosthetic arteriovenous grafts can be performed using surgical or endovascular techniques. We conducted a retrospective analysis to compare the efficacy of these two methods for restoring dialysis graft function. MATERIAL AND METHOD: We studied 41 patients who had received surgical thrombectomy with revision (Group A) or percutaneous thrombectomy with angioplasty (Group B) from January 2006 to December 2007. We compared them according to the patient characteristics and the location of stenotic lesions, and we analyzed the postintervention primary patency rates. RESULT: 21 patients underwent surgery and 20 patients underwent percutaneous balloon angioplasty. There were no significant differences of the patients' characteristics between the two groups. Venous anastomotic stenosis was the most common cause of graft thrombosis in both groups. In Group A, 90.5% of the grafts remained functional at 6 months and 38.1% remained functional at 12 months. In Group B, 55.0% of the grafts were functional at 6 months and 20.0% of the grafts were functional at 12 months. The post-intervention primary patency rate was significantly better in Group A (p=0.034). CONCLUSION: Surgical treatment resulted in significantly longer post-intervention primary patency in this study, and this supports its use as the primary method of management for most patients in whom dialysis graft obstruction develops.
Angioplasty ; Angioplasty, Balloon ; Arteriovenous Fistula ; Constriction, Pathologic ; Dialysis ; Endovascular Procedures ; Graft Occlusion, Vascular ; Humans ; Retrospective Studies ; Thrombectomy ; Thrombosis ; Transplants

OBJECTIVESTo evaluate the feasibility and effectiveness of stent placement in treating hepatic artery stenosis after orthotopic liver transplantation (OLT).

METHODSFrom November 2003 to September 2005, 14 patients who had hepatic artery stenosis after OLT underwent stent placement in their narrowed hepatic arteries. This included early interventional treatment in 10 patients and delayed interventional treatment in 4 patients. The technical results, clinical outcomes, and the hepatic artery patencies were reviewed.

RESULTSTechnical and immediate success was 100%. After a mean follow-up of 146 days (range, 9-345 days), all patients' hepatic arteries were patent, except that hepatic arterious restenosis occurred in 2 patients at 26 and 45 days after the stent placement. Of the 10 patients who received early treatment, 8 survived with normal results of liver function test and 2 patients died of septic multiple-organ failure at 9 and 30 days after the stent procedure. One patient received a retransplantation because of refractory biliary infection. Of the 4 patients who received a delayed interventional treatment, 1 patient survived for 345 days but with abnormal liver functional test results, the other 3 patients died of septic multiple-organ failure resulting from liver abscesses biliary infection.

CONCLUSIONHepatic artery stenosis after OLT can successfully be treated with stent placement and an early interventional treatment is the key for a good clinical outcome.

Adult ; Constriction, Pathologic ; therapy ; Female ; Graft Occlusion, Vascular ; etiology ; therapy ; Hepatic Artery ; surgery ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Stents ; Vascular Diseases ; etiology ; therapy

OBJECTIVE: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. MATERIALS AND METHODS: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. RESULTS: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates (+/- standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69% +/- 9 and 88% +/- 6, 41% +/- 10 and 88% +/- 6, 30% +/- 10 and 77% +/- 10, and 12% +/- 8 and 61% +/- 13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51% +/- 16 and 86% +/- 13 vs 45% +/- 15 and 73%+/-13 at 6 months, and 25% +/- 15 and 71% +/- 17 vs 23% +/- 17 and 73% +/- 13 at 12 months (p = .346 and .224), respectively. CONCLUSION: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.
Vascular Patency ; Treatment Failure ; Stents ; Renal Dialysis ; Polytetrafluoroethylene ; Middle Aged ; Metals ; Male ; Humans ; Graft Occlusion, Vascular/*therapy ; Forearm ; Female ; *Arteriovenous Shunt, Surgical ; *Angioplasty, Balloon ; Aged, 80 and over ; Aged