Percutaneous transluminal angioplasty of stenotic deep vein arterial bypass grafts

Successful percutaneous transluminal angioplasty was performed in six patients with lower-extremity vein-graft stenosis. In all patients we used autogenous, superficial femoral veins as the vein-graft material because the greater saphenous veins were too small or had been harvested for previous surgery. Angioplasty was performed on three men and three women (average age, 73 years). Stenosis of the vein graft was suspected in the presence of recurrent symptoms and physical signs of vascular insufficiency; additionally, Doppler pulse volume recordings of the ankle aided in the identification of patients with falling grafts. Angiography confirmed the presence of superficial femoral vein stenosis in all patients prior to balloon catheter dilation. On an average, angioplasty was performed approximately seven months following surgery; successful dilation was demonstrated by an increased luminal diameter seen arteriographically. Two of the six patients underwent a second angioplasty six months after the first procedure. Graft patency has been maintained in all six patients, as measured by clinical follow-up and Doppler pulse volume recordings. Arteriography was performed in the presence of recurrent symptoms or physical signs of diminished flow to the extremity. The oldest surviving grafts in this group of patients are 24 and 26 months, respectively.