INTERVENTIONAL RADIOLOGY IN THE MAINTENANCE OF INFRAINGUINAL VEIN GRAFT PATENCY

The impact of interventional radiology on the cumulative patency rate of 112 consecutive infrainguinal vein grafts was reviewed. The primary, primary assisted and secondary cumulative patency rates at 42 months were 40, 65 and 69 per cent respectively. The difference between primary and primary assisted patency rates (40 versus 65 per cent, P = 0.001) resulted from the early detection and treatment of stenoses in 30 grafts by percutaneous transluminal angioplasty (PTA). Interventional radiology also improved the cumulative graft patency rate through PTA of one inflow and five outflow arteries, thrombolysis of two graft occlusions, embolization of two persistent arteriovenous fistulas and salvage of one graft on the first day after operation by percutaneous aspiration of distal graft thrombus. Interventional radiology has a crucial role to play in the maintenance of infrainguinal vein graft patency; provided that graft stenoses are detected early in their development by aggressive graft surveillance, PTA is a highly effective treatment.