Infrainguinal graft failure: Clinical considerations

J. A. Freischlag

Research output: Contribution to journalArticle

Abstract

GRAFT FAILURES that occur in the first 30 days after operation are primarily due to technical error. For practical considerations, graft failure occurring after that initial period can be divided into three categories according to the location of the responsible obstructing lesion. These include the following: (1) atherosclerotic progression of aortoiliac (inflow) disease, (2) atherosclerotic progression of popliteal or tibialperoneal (outflow) disease, and (3) development of disease within the graft itself, (fibrosis, atherosclerosis) or its anastomoses (intimal hyperplasia). The patency rates of secondary infrainguinal reconstructions due to graft thrombosis are inferior to those grafts that are salvaged before thrombosis. Therefore, it is important to be able to identify which grafts are failing postoperatively prior to occlusion. Periodic evaluation of clinical status, primarily by symptomatology and pulse palpation, reinforced by noninvasive testing is necessary in order to determine the functional patency of the graft and should be performed frequently (every 3 months during the first postoperative year and every 6 months thereafter) to identify early any threat to graft patency.

Original languageEnglish (US)
Pages (from-to)35-37
Number of pages3
JournalSeminars in Vascular Surgery
Volume3
Issue number1
StatePublished - 1990

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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