Cutting balloon percutaneous transluminal angioplasty for salvage of lower limb arterial bypass grafts: feasibility

Radiology
Christoph EngelkeAnna-Maria Belli

Abstract

To evaluate the feasibility of cutting balloon percutaneous transluminal angioplasty (PTA) for treatment of neointimal hyperplasia in peripheral arterial bypass grafts. Fifteen consecutive patients (six women, nine men; age range, 57-89 years; mean age, 71 years) were treated with cutting balloon PTA for 16 anastomotic stenoses after infrainguinal bypass (prosthetic grafts, seven patients; prosthetic-vein composite grafts, two; venous grafts, five; and ileofemoral stent-graft, one). Cutting balloon PTA was followed by conventional PTA to improve anastomotic diameter. Patients with stenotic vein grafts underwent cutting balloon PTA after failed conventional PTA; the other patients were treated primarily with cutting balloon PTA. Criteria for success were a lumen diameter improvement of greater than 50% or residual stenosis of 20% or less. Follow-up was performed with color duplex ultrasonographic surveillance. Patency rates and durations were calculated with Kaplan-Meier survival curves and log-rank statistics. Attempted conventional PTA (n = 6) prior to cutting balloon PTA was unsuccessful. Cutting balloon PTA was technically successful in 15 (94%) of 16 lesions, without clinical complications. Two local restenoses and one graf...Continue Reading

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