BACKGROUND: Studies comparing alternative autologous vein grafts (AAVGs) to single-segment great saphenous vein (ssGSV) grafts report mixed results. The status of AAVG as first choice when ssGSV is unavailable is not unequivocal based on current evidence. Our study compares results between AAVG and ssGSV in lower extremity bypass (LEB) surgery. METHODS: A single-center retrospective cohort study involving all patients who underwent infrainguinal bypass using AAVG (arm veins, spliced arm, or arm-leg veins) and ssGSV from April 2019 to June 2023. Study endpoints were patency rates and amputation-free survival (AFS). RESULTS: There were 65 (20.8%) patients in the AAVG group, 247 (79.2%) in the ssGSV group. Chronic limb-threatening ischemia (CLTI) was the most frequent indication for surgery (AAVG 54/65, 83.1% vs. ssGSV 170/247, 68.8%), followed by acute limb ischemia (ALI) (AAVG 6/65, 9.2% vs. ssGSV 28/247, 11.3%); claudicants were presented only in the ssGSV group (AAVG 0/65, 0% vs. ssGSV 44/247, 17.8%). More redo operations occurred in AAVG than in the ssGSV group (23/65, 35.4% vs. 26/247, 10.5%; P < 0.001). Spliced vein grafts represented 87.7% (57/65) of AAVG bypasses. The median follow-up was 20.1 months for the AAVG group and 27.5 for the ssGSV group. Three-year patency rates between AAVG versus ssGSV: primary patency (PP) 59.3% ± 8.2% versus 69.2% ± 3.8%, P = 0.113; primary assisted patency (PAP) 75.2% ± 7.1% versus 73.5% ± 3.4%, P = 0.790; secondary patency (SP) 74.9% ± 7.1% versus 74.4% ± 3.4%, P = 0.667; did not display significant difference between groups nor did 3-year AFS in CLTI patients; 70.7% ± 7.9% versus 54.6% ± 4.8%; P = 0.273. CONCLUSION: AAVGs should be the first conduit choice when ssGSV is unavailable. Mid-term patency rates do not differ from those of ssGSV grafts despite higher reintervention rate.
- MeSH
- amputace MeSH
- autologní transplantace MeSH
- časové faktory MeSH
- dolní končetina * krevní zásobení MeSH
- ischemie * chirurgie patofyziologie diagnostické zobrazování MeSH
- lidé středního věku MeSH
- lidé MeSH
- okluze cévního štěpu patofyziologie etiologie chirurgie MeSH
- onemocnění periferních arterií * chirurgie patofyziologie diagnostické zobrazování mortalita MeSH
- průchodnost cév MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- transplantace cév * škodlivé účinky MeSH
- vena saphena * transplantace patofyziologie MeSH
- výsledek terapie MeSH
- záchrana končetiny MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
OBJECTIVE: Several factors are involved in the preservation of graft function after surgical myocardial revascularization. This follow-up study aimed to evaluate the effects of vein graft anastomosis and graft morphology on long-term graft patency a minimum of 10 years after aortocoronary bypass grafting.Setting and Cohorts. This was a sub-analysis of a study that enrolled patients after isolated bypass surgery at the University Hospital Ostrava in order to evaluate the long-term graft patency of the saphenous vein after endoscopic harvest, a minimum of 10 years after aortocoronary bypass grafting. METHODS: Fifty angiograms, with a total of 90 grafts, after isolated myocardial revascularization were visualized using coronary computed tomography angiography, with 50% luminal stenosis or greater considered significant. RESULTS: The overall graft patency rate was 72.3%. The differences in occlusion rates between sequential and individual grafts were not statistically significant (P=0.156). All y-grafts were totally occluded. Graft and target artery diameters had a statistically significant influence on patency (P=1.000 and 0.381, respectively). Longer graft length and higher calcium scores were associated with statistically significant graft occlusion (P=0.033 and 0.005, respectively). CONCLUSION: Sequential grafts can be constructed safely, especially when the goal is complete myocardial revascularization.
- Klíčová slova
- calcium score, graft length, graft morphology, graft patency, sequential graft, target quality,
- MeSH
- anastomóza chirurgická * MeSH
- CT angiografie MeSH
- koronární angiografie MeSH
- koronární bypass * metody škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- následné studie MeSH
- okluze cévního štěpu * etiologie patofyziologie MeSH
- průchodnost cév * MeSH
- senioři MeSH
- vena saphena * transplantace diagnostické zobrazování MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Alternative autologous veins can be used as a conduit when adequate great saphenous vein is unavailable. We analyzed the results of our infrainguinal bypasses after adopting upper extremity veins in our practice. METHODS: This is a single-center observational study involving all patients whose infrainguinal bypass involved the use of upper extremity veins between April 2019, when we began using arm veins, and February 2023. RESULTS: During the study period, 49 bypasses were done in 48 patients; mean age 68.1 ± 9.8; men 32 (66.7%); body mass index 28.0 ± 4.8; indications for surgery: chronic limb threatening ischemia 41 (83.7%); acute limb ischemia 3 (6.1%); complications of previous prosthetic 3 (6.1%), or autologous 2 (4.1%) bypass grafts. Vein splicing was used in 43 (87.8%) bypasses with 3-segment grafts being the most common (26; 53.1%). There were 24 (49.0%) femorotibial, 11 (22.4%) femoropopliteal, 9 (18.4%) femoropedal, and 5 (10.2%) extension jump bypass procedures. Eighteen (36.7%) operations were redo surgeries. Twenty-one (42.9%) bypasses were formed using only arm veins. The median follow-up was 12.9 months (4.5-24.2). Two bypasses occluded during the first 30 postoperative days (2/49; 4.1%). Overall 30-day, 1-year, and 2-year primary patency rates were 93.7% ± 3.5%, 84.8% ± 5.9%, and 80.6% ± 6.9%, and secondary patency (SP) rates were 95.8% ± 2.9%, 89.2% ± 5.3%, and 89.2% ± 5.3%. One-segment grafts had better patencies than 2-, 3-, and 4-segment grafts (1-year SP 100% ± 0% vs 87.6% ± 6.0%). Two-year amputation-free survival was 86.8% ± 6.5%; 2-year overall survival was 88.2% ± 6.6%. CONCLUSIONS: Integration of arm vein grafts in infrainguinal bypass practice can be done safely with low incidences of perioperative graft failure. One-segment grafts had better patencies than spliced vein grafts. The achieved early patency and amputation-free survival rates strongly encourage their use. In the absence of a single-segment great saphenous vein, upper extremity vein grafts should be the preferred conduit choice.
- MeSH
- amputace MeSH
- autologní transplantace * MeSH
- časové faktory MeSH
- horní končetina krevní zásobení MeSH
- lidé středního věku MeSH
- lidé MeSH
- okluze cévního štěpu etiologie patofyziologie chirurgie MeSH
- onemocnění periferních arterií * chirurgie patofyziologie diagnostické zobrazování MeSH
- průchodnost cév * MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- transplantace cév škodlivé účinky metody MeSH
- vena saphena transplantace MeSH
- vény transplantace chirurgie patofyziologie MeSH
- výsledek terapie MeSH
- záchrana končetiny MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
PURPOSE: Dysfunction and loss of patency of dialysis arteriovenous grafts (AVGs) are serious causes of morbidity in patients on dialysis. Various risk factors associated with shorter AVG patency have been blamed, but the results of the studies were controversial. The aim of this study was to assess if associated diseases, biochemical markers and other parameters associated with atherosclerosis influence patency of AVGs in a large vascular access centre. METHODS: We conducted a retrospective study that included patients with AVGs patent for at least 3 weeks after creation. We included variables associated with atherosclerosis into the analysis (coronary artery disease, diabetes mellitus, chronic heart failure, arterial hypertension, smoking history and cholesterol and triglyceride levels) and characteristics of the graft (shape, feeding artery).The data was assessed using log-rank (Cox-Mantel) test. The differences were shown using Kaplan-Meier graphs. The observation period was limited to 1000 days after access creation. RESULTS: Overall, 338 patients were included in the study. Significantly higher risk of access failure was associated with presence of coronary artery disease (p = 0.0035). Higher serum cholesterol levels were associated with longer survival of the graft in 1000 days of surveillance (p = 0.04). CONCLUSIONS: Coronary artery disease negatively influences the cumulative patency of vascular access. Higher serum cholesterol levels are associated with lower AVG failure risk over a 1000-day period, which probably corresponds to the worse disease status of the patients with lower cholesterol values.
- MeSH
- arteriovenózní zkrat škodlivé účinky metody MeSH
- biologické markery krev MeSH
- časové faktory MeSH
- cholesterol krev MeSH
- chronické selhání ledvin diagnóza epidemiologie terapie MeSH
- dialýza ledvin * MeSH
- dospělí MeSH
- dyslipidemie krev epidemiologie MeSH
- Kaplanův-Meierův odhad MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nemoci koronárních tepen epidemiologie MeSH
- nemocnice univerzitní MeSH
- okluze cévního štěpu epidemiologie patofyziologie MeSH
- proporcionální rizikové modely MeSH
- průchodnost cév * MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- biologické markery MeSH
- cholesterol MeSH
OBJECTIVES: Thrombolysis has been reported to be suboptimal in occluded vein grafts and cryopreserved allografts, and there are no data on the efficacy of thrombolysis in occluded cold stored venous allografts. The aim was to evaluate early outcomes, secondary patency and limb salvage rates of thrombolysed cold stored venous allograft bypasses and to compare the outcomes with thrombolysis of autologous bypasses. METHODS: This was a single center study of consecutive patients with acute and non-acute limb ischemia between September 1, 2000, and January 1, 2014, with occlusion of cold stored venous allografts, and between January 1, 2012, and January 1, 2014, with occlusion of autologous bypass who received intra-arterial thrombolytic therapy. RESULTS: Sixty-one patients with occlusion of an infrainguinal bypass using a cold stored venous allograft (n = 35) or an autologous bypass (n = 26) underwent percutaneous intra-arterial thrombolytic therapy. The median duration of thrombolysis was 20 h (IQR 18-24) with no difference between the groups (p = .14). The median follow up was 18.5 months (IQR 11.0-52.0). Secondary patency rates of thrombolysed bypass at 6 and 12 months were 44 ± 9% and 32 ± 9% in patients with a venous allograft bypass and 46 ± 10% and 22 ± 8% with an autologous bypass, with no difference between groups (p = .40). Limb salvage rates at 1, 6, and 12 months after thrombolysis in the venous allograft group were 83 ± 7%, 72 ± 8% and 63 ± 9%, and in the autologous group 91 ± 6%, 76 ± 9%, and 65 ± 13%, with no difference between groups (p = .69). CONCLUSIONS: Long-term results of thrombolysis of venous allograft bypasses are similar to those of autologous bypasses. Occluded cold stored venous allograft can be successfully re-opened in most cases with a favorable effect on limb salvage.
- Klíčová slova
- Infrainguinal bypass, Limb salvage, Thrombolysis, Venous allograft,
- MeSH
- alografty MeSH
- autologní štěp MeSH
- časové faktory MeSH
- cévy - implantace protéz škodlivé účinky MeSH
- fibrinolytika škodlivé účinky terapeutické užití MeSH
- ischemie diagnóza farmakoterapie etiologie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nízká teplota * MeSH
- odběr tkání a orgánů MeSH
- okluze cévního štěpu diagnóza farmakoterapie etiologie patofyziologie MeSH
- onemocnění periferních arterií diagnóza patofyziologie chirurgie MeSH
- průchodnost cév účinky léků MeSH
- retrospektivní studie MeSH
- senioři MeSH
- trombolytická terapie * škodlivé účinky MeSH
- uchovávání tkání metody MeSH
- vena saphena účinky léků patofyziologie transplantace MeSH
- výsledek terapie MeSH
- záchrana končetiny MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- fibrinolytika MeSH
BACKGROUND: The aim of this prospective single-centre study was to analyse the immediate results, failures and complications of percutaneous mechanical thrombectomy using the Rotarex catheter in the treatment of acute and subacute occlusions of peripheral arteries and bypasses, as well as to evaluate long-term outcomes of this method. PATIENTS AND METHODS: Patients with acute (duration of symptoms < 14 days) or subacute (duration of symptoms > 14 days and < 3 months) occlusions of peripheral arteries and bypasses were selected consecutively for treatment. The cohort consisted of 113 patients, aged 18-92 years (median 72 years). In all, 128 procedures were performed. RESULTS: Angiographic success was obtained in 120 interventions (93.8%). Reasons for failures were rethrombosis of a partially recanalised segment in six procedures, and embolism into crural arteries in one intervention--percutaneous aspiration thromboembolectomy (PAT) and/or thrombolysis were ineffective in all these cases. Breakage of the Rotarex catheter happened in one procedure. Embolisation into crural arteries as a transitory complication solvable with PAT and/or thrombolysis occurred in four cases. Rethrombosis was more frequent in bypasses than in native arteries (p = 0.0069), in patients with longer occlusions (p = 0.026) and those with poorer distal runoff (p = 0.048). Embolisation happened more often in patients with a shorter duration of symptoms (p = 0.0001). Clinical success was achieved in 82.5%. Major amputation was performed in 10% of cases. Cumulative patency rates were 75% after one month, 71% after six months, 38% after 12 months, 33% after 18 months and 30% after 24, 30, 36 and 42 months. CONCLUSIONS: Rotarex thrombectomy has excellent immediate results with a low rate of failures and complications. In comparison to thrombolysis, it enables the fast and efficient treatment of acute and subacute occlusions of peripheral arteries in one session.
- Klíčová slova
- Rotarex thrombectomy, peripheral arteries, thromboembolic occlusions,
- MeSH
- akutní nemoc MeSH
- amputace MeSH
- časové faktory MeSH
- cévní přístupy MeSH
- design vybavení MeSH
- dospělí MeSH
- intervenční radiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- okluze cévního štěpu diagnóza patofyziologie terapie MeSH
- onemocnění periferních arterií diagnóza patofyziologie terapie MeSH
- prospektivní studie MeSH
- průchodnost cév MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trombektomie škodlivé účinky přístrojové vybavení metody MeSH
- výsledek terapie MeSH
- záchrana končetiny MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
AIMS: We sought to identify biochemical predictors that indicate susceptibility to in-stent restenosis (ISR) after coronary artery bare-metal stenting. METHODS: A total of 111 consecutive patients with post-percutaneous coronary intervention (PCI) in-stent restenosis of a target lesion within 12 months were matched for age, sex, vessel diameter, and diabetes with 111 controls without post-PCI ISR. Plasma or serum levels of biochemical markers were measured: matrix metalloproteinases (MMP) 2, 3, 9; myeloperoxidase (MPO); asymmetric dimethylarginine (ADMA); lipoprotein (a) (Lp[a]); apolipoproteins E and D (ApoE and D); and lecitin-cholesterol acyltransferase (LCAT). Multivariable logistic regression association tests were performed. RESULTS: Increased plasma MMP-3 (OR: 1.013; 95% CI: 1.004-1.023; P = 0.005), MMP-9 (OR: 1.014; 95% CI: 1.008-1.020; P < 0.0001) or MPO (OR: 1,003; 95% CI: 1.001-1.005; P = 0.002) was significantly associated with increased risk of ISR. Increased levels of ADMA (OR: 0.212; 95% CI: 0.054-0.827; P = 0.026), ApoE (OR: 0.924; 95% CI: 0.899-0.951; P < 0.0001), ApoD (OR: 0.919; 95% CI: 0.880-0.959; P = 0.0001), or LCAT (OR: 0.927; 95% CI: 0.902-0.952; P < 0.0001) was associated with risk reduction. No correlation was found between plasma MMP-2 or Lp (a) and ISR risk. CONCLUSIONS: Increased levels of MMP-3, MMP-9, and MPO represent predictors of ISR after bare-metal stent implantation. In contrast, increased ADMA, LCAT, and Apo E and D indicate a decreased in-stent restenosis occurrence.
- Klíčová slova
- apolipoproteins D, apolipoproteins E, asymmetric dimethylarginine, in-stent restenosis, lecitin-cholesterol acyltransferase, matrix metalloproteinases, myeloperoxidase,
- MeSH
- apolipoproteiny D metabolismus MeSH
- apolipoproteiny E metabolismus MeSH
- arginin analogy a deriváty metabolismus MeSH
- biologické markery metabolismus MeSH
- koronární angioplastika MeSH
- koronární restenóza diagnóza patofyziologie MeSH
- lecitincholesterolacyltransferasa metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipoprotein (a) metabolismus MeSH
- matrixová metaloproteinasa 3 metabolismus MeSH
- matrixová metaloproteinasa 9 metabolismus MeSH
- okluze cévního štěpu diagnóza patofyziologie MeSH
- peroxidasa metabolismus MeSH
- průchodnost cév fyziologie MeSH
- senioři MeSH
- stenty * MeSH
- studie případů a kontrol MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- apolipoproteiny D MeSH
- apolipoproteiny E MeSH
- arginin MeSH
- biologické markery MeSH
- lecitincholesterolacyltransferasa MeSH
- lipoprotein (a) MeSH
- matrixová metaloproteinasa 3 MeSH
- matrixová metaloproteinasa 9 MeSH
- N,N-dimethylarginine MeSH Prohlížeč
- peroxidasa MeSH
Stenosis is the most frequent vascular access complication and is responsible for access thrombosis and thus long-term patency limitation. Regular arteriovenous graft (AVG) examination by ultrasonography and preemptive balloon angioplasty prolong AVG cumulative patency according to some, but by far not all trials. This was why the routine use of ultrasound surveillance is not recommended recently.In this review we show huge differences in the definition of stenosis significance among the trials and other probable factors, which may have caused the contradiction of the results. Without precise definition of stenosis significance, many AVGs have been undergoing unnecessary balloon interventions with high morbidity, high cost and low benefit.
- MeSH
- arteriovenózní zkrat škodlivé účinky MeSH
- cévy - implantace protéz škodlivé účinky MeSH
- dialýza ledvin * MeSH
- duplexní dopplerovská ultrasonografie * MeSH
- lidé MeSH
- okluze cévního štěpu diagnostické zobrazování etiologie patofyziologie MeSH
- prediktivní hodnota testů MeSH
- průchodnost cév MeSH
- regionální krevní průtok MeSH
- rychlost toku krve MeSH
- trombóza diagnostické zobrazování etiologie patofyziologie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: Hybrid endovascular and open reconstructions are used increasingly often for multilevel revascularization for lower limb ischaemia. The aim was to evaluate outcomes after such procedures in a single-center non-randomized retrospective study. PATIENTS AND METHODS: Consecutive patients with multilevel arterial disease who underwent single session hybrid procedures were analyzed depending on the type of ischaemia and the type of revascularization. RESULTS: 164 patients were included with a median follow up time of 14 months (range: 0 - 70). Indication was claudication (group 1, 47 %), critical limb ischaemia (group 2, 33 %) and acute limb ischaemia (group 3, 20 %). Technical success rate was 99.3 %, perioperative mortality 2 %. Primary, assisted-primary and secondary patency rates at one year were 60 %, 61 % and 64 %, respectively. Primary, primary assisted and secondary patency were lower in group 2 and 3 compared to group 1 (all p < 0.05). Results were better when endovascular repairs were performed above compared to below the open repair site (all p < 0.05). Limb salvage at 1 year in groups 1 - 3 were 98 %, 92 % and 90 %, respectively. The risk of major amputation was highest in group 3 compared to group 1 (p = 0.001) or group 2 (p < 0.04). CONCLUSIONS: The results depend on the type of ischaemia and the localization of endovascular procedures.
Hintergrund: Endovaskuläre und offene Hybridoperationen werden immer häufiger bei mehrstufiger Ischämie der unteren Extremitäten eingesetzt. Das Ziel dieser Studie ist, die Ergebnisse nach solchen OP-Verfahren in einer monozentrischen, nicht randomisierten retrospektiven Studie zu evaluieren. Patienten und Methoden: Konsekutive Patienten mit mehrstufiger arterieller Verschlusskrankheit, die in einer einzigen Sitzung mit einer Hybrid-OP behandelt wurden, wurden in Abhängigkeit vom Ausmaß der Ischämie und Art der Revaskularisation analysiert. Ergebnisse: 164 Patienten mit einer medianen Beobachtungszeit von 14 Monaten (Bereich: 1 - 70) wurden ausgewertet. OP-Indikation waren belastungsabhängige Schmerzen mit Einschränkung der Gehstrecke (Claudicationsschmerz) (Gruppe 1, 47 %), kritische Extremitätenischämie (Gruppe 2, 33 %) und akute Ischämie (Gruppe 3, 20 %). Die technische Erfolgsrate lag bei 99.3 %, die perioperative Mortalität bei 2 %. Primäre, primär-assistierte und sekundäre Raten nach einem Jahr waren 60 %, 61 % und 64 %. Primar-assistierte und sekundäre Durchblutung waren niedriger in Gruppe 2 und 3 im Vergleich zu Gruppe 1 (alle p < 0.05). Die Ergebnisse waren besser, wenn die endovaskuläre Reparatur oberhalb im Vergleich zu unterhalb der offenen Reparaturstelle durchgeführt wurde (alle p < 0.05). Extremitätenerhaltsraten nach 1 Jahr in Gruppen 1, 2 und 3 waren 98 %, 92 % und 90 %. Das Risiko einer größeren Amputation war höher in der Gruppe 3 im Vergleich zu Gruppe 1 (p = 0.001) oder der Gruppe 2 (p < 0.04). Schlussfolgerungen: Die Ergebnisse hängen von der Art der Ischämie und der Lokalisation der endovaskulären Eingriffen ab.
- MeSH
- amputace MeSH
- analýza rozptylu MeSH
- angioplastika * škodlivé účinky přístrojové vybavení mortalita MeSH
- časové faktory MeSH
- cévy - implantace protéz * škodlivé účinky mortalita MeSH
- dospělí MeSH
- Kaplanův-Meierův odhad MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- okluze cévního štěpu etiologie patofyziologie terapie MeSH
- onemocnění periferních arterií mortalita patofyziologie chirurgie terapie MeSH
- přežití bez známek nemoci MeSH
- průchodnost cév MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- rozdělení chí kvadrát MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stenty MeSH
- výsledek terapie MeSH
- záchrana končetiny MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
PURPOSE: The purpose of this paper is to assess a long-term outcome of allogenous vein grafts (ALVG) as vascular access for hemodialysis. MATERIALS AND METHODS: For nearly eight years (between 9/2002 and 9/2011) a total of 78 patients with 112 ALVGs were involved in the study. The register included 46 women and 32 men, mean age 66.1 ± 11.2 years; range 20-88 years. The patient database was retrospectively reviewed and statistical processing was performed. RESULTS: Almost all ALVGs were treated by PTA or surgically, very often repeatedly. The number of radiologic interventions was 316, the number of surgical procedures 31. Mean follow-up time was 795 days, range 28-3522 days. Thirty-five patients died of unrelated causes, nineteen with functional graft, fourteen patients were lost to follow-up. Forty ALVGs failed for various reasons, mostly because of occlusion. Only one patient underwent successful renal transplantation, no patient converted to peritoneal dialysis. Thirty-seven ALVGs remain correctly functioning. Primary patency rates at 6, 12, and 24 months were 81 ± 5%, 63 ± 5%, and 34 ± 2% respectively. Secondary patency rates at 6, 12, and 24 months were 96 ± 2%, 82 ± 4%, and 65 ± 5% respectively. CONCLUSIONS: Allogenous vein grafts, in spite of the high number of necessary radiologic and surgical interventions and reinterventions, show acceptable clinical usability and durability, comparable with other types of prosthetic grafts.
- MeSH
- arteriovenózní zkrat škodlivé účinky metody MeSH
- balónková angioplastika MeSH
- časové faktory MeSH
- cévy - implantace protéz MeSH
- dialýza ledvin * MeSH
- dospělí MeSH
- flebografie MeSH
- Kaplanův-Meierův odhad MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- okluze cévního štěpu etiologie patofyziologie terapie MeSH
- průchodnost cév MeSH
- registrace MeSH
- reoperace MeSH
- retrospektivní studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trombóza etiologie patofyziologie terapie MeSH
- vény transplantace MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH