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graft restenosis

Marc Garbey, Stefano Casarin, Scott A Berceli
Peripheral arterial occlusive disease is a chronic pathology affecting at least 8-12 million people in the USA, typically treated with a vein graft bypass or through the deployment of a stent in order to restore the physiological circulation. Failure of peripheral endovascular interventions occurs at the intersection of vascular biology, biomechanics, and clinical decision making. It is our hypothesis that the majority of endovascular treatment approaches share the same driving mechanisms and that a deep understanding of the adaptation process is pivotal in order to improve the current outcome of the procedure...
August 9, 2018: Biomechanics and Modeling in Mechanobiology
Miguel Lemos Gomes, Alice Lopes, Gonçalo Sobrinho, Luis Mendes Pedro
Introduction: Renal venous graft restenosis is an uncommon event usually associated with significant clinical impact. Its treatment by endovascular stenting is seldom reported in the literature. Report: Two cases of successful stenting for restenosis in aorto-renal venous grafts are described, detailing the technique and in one case reporting for the first time the use of a covered stent in this condition. Discussion: Technical success may be achieved with proper material selection for the patient's anatomy and with dilation at relatively high pressures...
2018: EJVES Short Reports
Patrick Björkman, Tatu Kokkonen, Anders Albäck, Maarit Venermo
OBJECTIVE: Stenosis is a known complication in bypass vein grafts for peripheral arterial disease (PAD). The aim of this study was to evaluate the effect of drug-coated balloons (DCB) in the treatment of vein graft stenoses. SUMMARY BACKGROUND DATA: DCBs may prevent restenosis in arterial lesions. One small prospective, and larger retrospective and registry studies have failed to show benefit from DCBs in vein grafts. Prospective data are scarce. MATERIALS AND METHODS: 60 patients treated for primary or recurrent stenosis in venous bypass grafts were randomized to DCB (n=30) or standard balloon angioplasty (BA) (n=30)...
August 6, 2018: Annals of Vascular Surgery
Rahul Sharma, Michael Tradewell, Louis P Kohl, Ross F Garberich, Jay H Traverse, Anil Poulose, Emmanouil S Brilakis, Theresa Arndt, Timothy D Henry
BACKGROUND: A significant proportion of patients with complex, advanced coronary artery disease have refractory angina (RA) despite maximal pharmacological therapy and are deemed suboptimal candidates for revascularization. These patients are frequently termed "no-option" patients. However, despite this designation, many subsequently undergo coronary revascularization. We sought to determine the incidence, etiology and outcome of revascularization in "no-option" patients...
August 5, 2018: Catheterization and Cardiovascular Interventions
Scott O Trerotola, Jeffrey Lawson, Prabir Roy-Chaudhury, Theodore F Saad
BACKGROUND: Restenosis remains a problem in hemodialysis access interventions. Paclitaxel-coated balloons have shown promise in reducing access-related restenosis in small trials. The primary hypotheses for our multicenter trial were superior effectiveness at 180 days and noninferior safety at 30 days of a drug-coated balloon compared with conventional angioplasty for treatment of dysfunctional arteriovenous fistulas. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This randomized trial enrolled 285 patients with dysfunctional arteriovenous fistulas at 23 centers...
August 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Farah Gillan Irani, Terence Kiat Beng Teo, Kiang Hiong Tay, Win Htet Yin, Hlaing Hlaing Win, Apoorva Gogna, Ankur Patel, Chow Wei Too, Shaun Xavier Ju Min Chan, Richard Hoau Gong Lo, Luke Han Wei Toh, Siew Ping Chng, Hui Lin Choong, Bien Soo Tan
Purpose To compare lesion primary patency and restenosis rates between drug-eluting balloon (DEB) percutaneous transluminal angioplasty (PTA) and conventional balloon PTA (cPTA) in the treatment of arteriovenous fistula (AVF) and arteriovenous graft (AVG) stenosis. Materials and Methods In this prospective study, 119 participants (mean age, 59.2 years; 79 men, 40 women) with failing AVFs (n = 98) or AVGs (n = 21) were randomly assigned to undergo either DEB PTA (n = 59) or cPTA (n = 60) from January 2012 to May 2013...
July 24, 2018: Radiology
J Zheng, J Cui, J Meiyan Qing, Z Irani
PURPOSE: To evaluate the safety and effectiveness of combined scoring balloon (SB) and paclitaxel-coated balloon (PCB) angioplasty for stenosis in the dysfunctional hemodialysis access circuit. MATERIAL AND METHODS: Patients were referred from outpatient dialysis centers by their nephrologists because of dysfunctional dialysis access circuit. Fistulogram/graftogram was performed by experienced interventional radiologists. Those with in-stent stenosis, stent edge stenosis or vessel diameter at the culprit segment larger than 6mm were excluded...
July 16, 2018: Diagnostic and Interventional Imaging
A C B S Cavalcante, C E Zurstrassen, F C Carnevale, R P S Pugliese, E A Fonseca, A M Moreira, Jpk Matushita, H L L Cândido, M A R Benavides, I K Miura, V L B Danesi, A P M Hirschfeld, C B V Borges, G Porta, P ChapChap, J Seda-Neto
Portal vein thrombosis (PVT) may occur at any time following liver transplantation. We describe our experience with portal vein recanalization in cases of thrombosis after liver transplantation. Twenty-eight children (5%) out of 566 liver transplant recipients underwent portal vein recanalization using a transmesenteric approach. All children received left hepatic segments, developed PVT and had symptoms or signs of portal hypertension. Portal vein recanalization was performed via the transmesenteric route in all cases...
July 18, 2018: American Journal of Transplantation
Sandra L Arias, Akshath Shetty, Joshua Devorkin, Jean-Paul Allain
Tissue-engineered vascular grafts (TEVG) use biologically-active cells with or without supporting scaffolds to achieve tissue remodeling and regrowth of injured blood vessels. However, this process may take several weeks because the high hemodynamic shear stress at the damaged site causes cellular denudation and impairs tissue regrowth. We hypothesize that a material with magnetic properties can provide the force required to speed up re-endothelization at the vascular defect by facilitating high cell density coverage, especially during the first 24 h after implantation...
July 10, 2018: Acta Biomaterialia
Conor McQuillan, Alastair Gray, Aileen Kearney, Ian B A Menown
INTRODUCTION: Numerous important cardiology clinical trials have been published or presented at major international meetings during 2017. This paper aims to summarize these trials and place them in clinical context. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2017 including the American College of Cardiology, European Association for Percutaneous Cardiovascular Interventions, European Society of Cardiology, European Association for the Study of Diabetes, Transcatheter Cardiovascular Therapeutics, and the American Heart Association...
July 2018: Advances in Therapy
Mahmoud B Malas, Hanaa Dakour-Aridi, Grace J Wang, Vikram S Kashyap, Raghu L Motaganahalli, Jens Eldrup-Jorgensen, Jack L Cronenwett, Marc L Schermerhorn
BACKGROUND: Recent evidence from the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial in high-risk patients undergoing transcarotid artery stenting with dynamic flow reversal reported the lowest stroke rate compared with any prospective trial of carotid artery stenting. However, clinical trials have selection criteria that exclude many patients from enrollment and are highly selective of operators performing the procedures, which limit generalizability...
June 13, 2018: Journal of Vascular Surgery
Kexin He, Lili Zhao, Shoushan Bu, Li Liu, Xiang Wang, Min Wang, Zhining Fan
 Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. METHODS : Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation...
June 11, 2018: Endoscopy
Vincenzo Li Marzi, Riccardo Campi, Francesco Sessa, Alessandro Pili, Graziano Vignolini, Mauro Gacci, Michele Marzocco, Eugenio Dattolo, Enrico Minetti, Mariella Santini, Massimo Gatti, Adriano Peris, Sergio Serni
Transplant renal artery stenosis (TRAS) is the most frequent vascular complication after kidney transplantation (KT) and has been associated with potentially reversible refractory hypertension, graft dysfunction, and reduced patient survival. The aim of the study is to describe the outcomes of a standardized Duplex Ultrasound- (DU-) based screening protocol for early diagnosis of TRAS and for selection of patients potentially requiring endovascular intervention. We retrospectively reviewed our prospectively collected database of KT from January 1998 to select patients diagnosed with TRAS...
2018: BioMed Research International
Julian Braetz, Astrid Becker, Markus Geissen, Axel Larena-Avellaneda, Sonja Schrepfer, Guenter Daum
OBJECTIVE: The main objective of this study was to define a role of sphingosine-1-phosphate receptor 1 (S1PR1) in the arterial injury response of a human artery. The hypotheses were tested that injury induces an expansion of S1PR1-positive cells and that these cells accumulate toward the lumen because they follow the sphingosine-1-phosphate gradient from arterial wall tissue (low) to plasma (high). METHODS: A humanized rat model was used in which denuded human internal mammary artery (IMA) was implanted into the position of the abdominal aorta of immunosuppressed Rowett nude rats...
May 24, 2018: Journal of Vascular Surgery
Qiang Liu, Xiujie Yin, Mingzhu Li, Li Wan, Liqiao Liu, Xiang Zhong, Zhuoqi Liu, Qun Wang
Occlusive artery disease (CAD) is the leading cause of death worldwide. Bypass graft surgery remains the most prevalently performed treatment for occlusive arterial disease, and veins are the most frequently used conduits for surgical revascularization. However, the clinical efficacy of bypass graft surgery is highly affected by the long-term potency rates of vein grafts, and no optimal treatments are available for the prevention of vein graft restenosis (VGR) at present. Hence, there is an urgent need to improve our understanding of the molecular mechanisms involved in mediating VGR...
2018: PeerJ
Tisa Saha, Syed Yaseen Naqvi, Sheldon Goldberg
Hybrid coronary revascularization (HCR) combines surgical bypass with percutaneous coronary intervention (PCI) performed either during the same procedure or in a staged approach within 60 days. Coronary artery bypass grafting using the left internal mammary artery (LIMA) has shown excellent long-term patency with improved patient survival. It remains the gold standard treatment for the majority of patients with multivessel coronary artery disease. However, saphenous vein grafts have poor long-term patency. Advances in stent technology have resulted in reduced rates of thrombosis and restenosis, making PCI a viable alternative to coronary surgery in selected patients...
2018: Cardiology
Bart Dolmatch, Andrew Hogan, Nicole Ferko
PURPOSE: To conduct an economic analysis on the impact of increased stent graft (SG) use for treatment of arteriovenous graft (AVG) anastomotic stenosis or arteriovenous fistula (AVF)/AVG in-stent restenosis (ISR) from United States point-of-care (POC) and Medicare perspectives. MATERIALS AND METHODS: The analyses compared initial device and reintervention costs over 2 years between current and projected treatment mixes, including percutaneous transluminal angioplasty (PTA), bare metal stents (BMSs), and SGs...
June 2018: Journal of Vascular and Interventional Radiology: JVIR
Maurizio Domanin, Silvia Lanfranconi, Silvia Romagnoli, Letterio Runza, Francesca Cortini, Giacomo Piero Comi, Livio Gabrielli
Extracranial carotid artery aneurysms (ECAA) are a rare cause of embolic stroke. The underlying etiology is variable, with atherosclerosis being the most common entity in older subjects. Several treatments have been developed over the last 20 years, but the preferred method remains unknown. Notwithstanding the widespread use of endovascular techniques, surgical reconstruction by means of a bifurcated venous bypass graft should be applied in younger patients. In this way, it is possible to avoid major concerns about the development of long-term intrastent restenosis, and also to spare the external carotid artery which represents the main branch for the ipsilateral cerebral and facial perfusion...
2018: Pediatric Neurosurgery
Ting-Chao Lin, Chun-Yang Huang, Po-Lin Chen, Chiu-Yang Lee, Chun-Che Shih, I-Ming Chen
PURPOSE: To report a retrospective analysis of risk factors for edge restenosis after Viabahn stent-graft treatment of superficial femoral artery (SFA) occlusive disease and determine any protective effect of drug-coated balloons (DCBs) used at the time of stent-graft implantation. METHODS: Between October 2011 and July 2016, 110 patients (mean age 73.3±7.6 years; 78 men) were treated with the Viabahn stent-graft for long SFA occlusions. Thirty-eight (34.5%) patients had DCB reinforcement at the distal edge of the stent-graft...
June 2018: Journal of Endovascular Therapy
Rafał A Januszek, Artur Dziewierz, Zbigniew Siudak, Tomasz Rakowski, Dariusz Dudek, Stanisław Bartuś
BACKGROUND: During the first decade following the coronary bypass grafting, at least 10 of the patients require percutaneous coronary interventions (PCI) due to graft failure. Saphenous vein grafts (SVG) are innately at a higher risk of periprocedural complications. The present study aimed to investigate predictors of periprocedural complications of PCI within coronary artery bypass grafts. METHODS: This study analyzed data gathered in the Polish National Registry (ORPKI) between January 2015 and December 2016...
April 19, 2018: Cardiology Journal
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