[Management of anastomotic stenosis after lower extremity bypass surgery with cutting balloon angioplasty]

J Radiol. 2010 Jan;91(1 Pt 1):47-51. doi: 10.1016/s0221-0363(10)70005-6.
[Article in French]

Abstract

Purpose: Conventional balloon angioplasty of anastomotic stenosis following bypass surgery is insufficient at mid- and long-term. However, short-term results with cutting balloon angioplasty (CBA) are satisfactory. The purpose of this study is to determine the long-term results using this technique. Materials and methods. Between January 2002 and January 2006, all patients with anastomotic stenosis more than one month after bypass surgery, shorter than 2 cm and>50%, were referred without randomisation to CBA.

Results: A total of 19 patients with mean age of 63.5 years (55-82 years), 14 males and 5 females, were included. Twenty stenoses (femoral n=15, popliteal n=4 and calf n=1) managed with CBA affected 17 infrainguinal and 2 suprainguinal bypasses. One patient had anastomotic stenoses at both extremities. The rate of technical success aws 100%. Mean follow-up was 32 months (12-42). Three deaths occurred during follow-up. One patient presented with restenosis at 3 months, successfully treated with repeat CBA. No thrombosis or infection was observed.

Conclusion: The results with CBA appear persistent and compete favorably with results from surgical repair. A randomized trial would be necessary to confirm these results.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / methods*
  • Angiography
  • Angioplasty, Balloon / methods*
  • Arteriovenous Shunt, Surgical / methods*
  • Female
  • Graft Occlusion, Vascular / diagnostic imaging
  • Graft Occlusion, Vascular / surgery*
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / surgery*
  • Leg / blood supply*
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / surgery*