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Is endovascular therapy effective in acute femoropopliteal bypass graft failure?
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Original Article
VOLUME: 52 ISSUE: 1
P: 144-154
2019

Is endovascular therapy effective in acute femoropopliteal bypass graft failure?

Acta Haematol Oncol Turc 2019;52(1):144-154
DOI: 10.5505/aot.2019.03064
Şehnaz Tezcan 1
Umut Özyer 2
Funda Ulu Öztürk 2
Hakkı Tankut Akay 3
Fatih Boyvat 2
1. Koru Hospital, Department Of Radiology, Ankara, Turkey
2. Baskent University, Department Of Radiology, Ankara, Turkey
3. Baskent University, Department Of Cardiovascular Surgery, Ankara, Turkey
4.
No information available.
No information available
Received Date: 2019-01-27T14:23:11
Accepted Date: 2019-04-09T13:42:18
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Abstract

INTRODUCTION

The purpose of this study was to evaluate the role of endovascular therapy in femoropopliteal bypass graft failure.

METHODS

Fifty seven (39 thrombosed grafts, 18 stenosed grafts) endovascular interventions were performed to 40 grafts. Endovascular treatment (EVT) options were catheter directed intra-arterial thrombolytic therapy, percutaneous transluminal angioplasty and stent placement. After EVT, the duration of patency was analyzed with Kaplan-Meier analysis and statistical significance of differences between groups was evaluated with Log-Rank method.

RESULTS

The initial successes of EVT in the thrombosed and stenosed grafts were 74.3 % and 100%, respectively. The initial success rates of EVT in the SV grafts and PTFE grafts were 90% and 78.5%, respectively. The primary patentcy (p = 0.01), assisted primary patency rates (p = 0.03) were significantly higher in thrombosed polytetrafluoroethylene (PTFE) grafts than saphenous vein (SV) grafts. There was no significant difference between patency rates of stenosed PTFE and SV grafts. We found no significant difference between patency rates among thrombolytic agents. The total complication rates were 23% in thrombosed grafts and 11.1% in stenosed grafts.

DISCUSSION AND CONCLUSION

EVT plays an important role in the treatment of thrombosed and stenosed grafts due to advantages of being cost-effective, having an easy application and being available for serial interventions for refractory lesions. Furthermore, EVT is more effective in thrombosed PTFE grafts than SV grafts, thus we consider that EVT is the best alternative for thrombosed PTFE grafts, especially in the high surgical risk patients.