Naoki Fujimura1,2, Hideaki Obara3, Kazuomi Iwasa4, Tsutomu Hattori5, Hiroshi Yamamoto6, Susumu Watada7, Taira Kobayashi8, Nobuhiro Suematsu9, Hiroshi Mitsuoka10, Yoshimitsu Soga11, Tatsuya Nakama12, Ryohei Sakamoto13, Shigeo Ichihashi14. 1. Division of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 2. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. 3. Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. obara.z3@keio.jp. 4. Department of Vascular Surgery, Matsuyama Red Cross Hospital, Ehime, Japan. 5. Department of Vascular Surgery, Sagamihara Kyodo Hospital, Kanagawa, Japan. 6. Department of Radiology, Sumitomo Hospital, Nara, Japan. 7. Department of Surgery, Kawasaki Municipal Hospital, Kanagawa, Japan. 8. Department of Cardiovascular Surgery, JA Hiroshima General Hospital, Hiroshima, Japan. 9. Department of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan. 10. Department of Cardiovascular Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan. 11. Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan. 12. Department of Cardiology, Tokyobay UrayasuIchikawa Medical Center, Chiba, Japan. 13. Department of Cardiology, Nakadori General Hospital, Akita, Japan. 14. Department of Radiology, Nara Medical University, Nara, Japan.
Abstract
PURPOSE: To describe a multi-center preliminary experience of treating prosthetic above knee femoropopliteal (AKFP) bypass occlusion by placing a Viabahn stent graft inside the occluded prosthetic bypass graft. MATERIALS AND METHODS: Retrospective analysis of consecutive 14 patients (mean age 73.2 ± 10.2, 78.6% male) receiving Viabahn stent graft inside the occluded prosthetic bypass graft for the treatment of prosthetic AKFP bypass occlusion in the collaborating hospitals from November 2016 to June 2019 was performed. RESULTS: Technical success was achieved in all patients. Mean lesion length was 34.0 ± 3.5 cm, concomitant thrombectomy or thrombus aspiration was performed in 11 patients (78.6%), and average of 1.57 ± 0.65 Viabahn stent grafts were used. Mean ankle-brachial index improved from 0.24 ± 0.23 to 0.98 ± 0.14 after the treatment. All patients had preoperative ischemic symptoms with 9 patients (64.3%) having Rutherford class > 4 symptoms; however, all preoperative symptoms resolved after the treatment. During the mean follow-up of 450.9 ± 234.7 days, there were two target lesion revascularizations, leading to a primary patency rate of 92.9% and a secondary patency of 100.0% at 1 year. CONCLUSION: Placing a Viabahn stent graft inside the occluded prosthetic bypass graft for the treatment of prosthetic AKFP bypass occlusion appears to be effective from our preliminary experience. Even though sample size is limited in our study, it may be considered as a potential treatment option before surgical reintervention.
PURPOSE: To describe a multi-center preliminary experience of treating prosthetic above knee femoropopliteal (AKFP) bypass occlusion by placing a Viabahn stent graft inside the occluded prosthetic bypass graft. MATERIALS AND METHODS: Retrospective analysis of consecutive 14 patients (mean age 73.2 ± 10.2, 78.6% male) receiving Viabahn stent graft inside the occluded prosthetic bypass graft for the treatment of prosthetic AKFP bypass occlusion in the collaborating hospitals from November 2016 to June 2019 was performed. RESULTS: Technical success was achieved in all patients. Mean lesion length was 34.0 ± 3.5 cm, concomitant thrombectomy or thrombus aspiration was performed in 11 patients (78.6%), and average of 1.57 ± 0.65 Viabahn stent grafts were used. Mean ankle-brachial index improved from 0.24 ± 0.23 to 0.98 ± 0.14 after the treatment. All patients had preoperative ischemic symptoms with 9 patients (64.3%) having Rutherford class > 4 symptoms; however, all preoperative symptoms resolved after the treatment. During the mean follow-up of 450.9 ± 234.7 days, there were two target lesion revascularizations, leading to a primary patency rate of 92.9% and a secondary patency of 100.0% at 1 year. CONCLUSION: Placing a Viabahn stent graft inside the occluded prosthetic bypass graft for the treatment of prosthetic AKFP bypass occlusion appears to be effective from our preliminary experience. Even though sample size is limited in our study, it may be considered as a potential treatment option before surgical reintervention.