Endovascular Rescue of Long-Term Patent Degenerating Grafts
Thomas Bernik, MD, Mohsen Bannazadeh, MD, Phillip Bahramipour, MD, Herbert Dardik, MD.
Englewood Hospital & Med. Center, Englewood, NJ, USA.
OBJECTIVES: Post-operative surveillance of vascular reconstructions is recommended for surveillance and suspicion of new pathologies. This has become routine for aortic endovascular procedures; occasionally performed for medium-sized arterial revascularization, open or endo, and more often discontinued after years of followup. Two recent cases demonstrate the need for continued surveillance regardless of time after the procedure and the particular materials employed.
METHODS: Two patients with long-term (greater than 10 years) functioning grafts were found to have concomitant degeneration of their conduits: an aortic dacron graft in case 1 and afemoral popliteal umbilical vein bypass graft case 2. Endovascular salvage was undertaken in both cases.
RESULTS:
Endovascular salvage (EVAR) of the dacron aortic graft (case 1) was performed after 27 years of service. The femoropopliteal graft (case 2)was salvaged after 16 years of service by placement of seven overlapping stent grafts within the bypass. An additional stent graft was required 2 years later for a single symptomatic endoleak. CONCLUSIONS:
Endovascular salvage of long-term graft degeneration is possible. This requires continued surveillance of all vascular reconstructions even after decades of function and apparent normalcy.
Back to 2017 ePosters
