Management of infrainguinal occluded vein bypasses with a combined approach of thrombolysis and surveillance. A prospective study.

Journal Article (Journal Article)

Intra-arterial thrombolysis with urokinase was attempted on 23 occluded infrainguinal vein bypasses. Lesions revealed by thrombolysis included 11 anastomotic stenoses, five midbypass stenoses, five native artery stenoses, and five unusable diffusely stenotic vein conduits. Adjunctive procedures performed immediately after successful thrombolysis included 10 local surgical revisions, five balloon angioplasties, and five new vein bypasses. Three nonanastomotic vein bypass stenoses and two common iliac artery stenoses were detected using a surveillance protocol in subsequent follow-up of patients with patent bypasses. Twelve-month patency following thrombolysis (including immediate failures) was 52.4%. The use of thrombolysis in the management of occluded vein bypasses allows the identification and correction of pathological lesions. Once revised, continued vein bypass patency may be improved with a surveillance program.

Full Text

Duke Authors

Cited Authors

  • Miller, BV; Sharp, WJ; Hoballah, JJ; Kresowik, TF; Cragg, AH; Smith, TP; Hakagawa, N; Brummer, M; Corson, JD

Published Date

  • August 1992

Published In

Volume / Issue

  • 127 / 8

Start / End Page

  • 986 - 989

PubMed ID

  • 1386507

International Standard Serial Number (ISSN)

  • 0004-0010

Digital Object Identifier (DOI)

  • 10.1001/archsurg.1992.01420080120020


  • eng

Conference Location

  • United States