New angioscopic findings in graft failure after infrainguinal bypass
A. Miller, S. J. Jepsen, P. A. Stonebridge, A. Tsoukas, G. W. Gibbons, F. B. Pomposelli Jr, D. V. Freeman, D. R. Campbell, F. J. Schoen and F. W. LoGerfo
Department of Surgery, New England Deaconess Hospital, Boston, Mass 02215.
We have previously shown that intraoperative angioscopy is a safe, useful,
and effective method for monitoring infrainguinal bypass grafts. The
videotaped recordings of the intraoperative angioscopy studies of 25 failed
infrainguinal bypass grafts inserted between May 1987 and July 1989 and 3
failing grafts that were angioscoped during the subsequent graft salvage
procedure were reviewed in a systematic fashion according to a fixed
protocol, to identify any endovascular findings either initially missed or
in which the relevance to graft failure had been unappreciated at the time
of bypass grafting. We were able to identify new venous pathologic
characteristics and highlight endoluminal features, of both a technical and
nontechnical nature, which have a probable causal relationship to graft
failure. However, the significance of some of the endovascular findings
that were seen during infrainguinal bypass grafting has yet to be fully
defined.