Percutaneous transluminal angioplasty of infrainguinal vein graft stenosis: long-term outcome.

The aim of this prospective study was to examine the long-term outcome of infrainguinal vein graft stenosis managed by percutaneous transluminal angioplasty (PTA) as first-line treatment. Thirty-three infrainguinal vein graft stenoses detected by graft surveillance during a 44-month period were treated initially by PTA. The median (range) follow-up after angioplasty was 39 (18-56) months. Although 19 stenoses were successfully treated by a single PTA, 14 stenoses recurred at a median (range) interval of 8.5 (1-39) months. Restenosis occurred more frequently in the distal third of a graft (P = 0.002) compared with that in the proximal or mid-grafts, and restenosis was more common in in situ than reversed vein grafts (P = 0.03). It is concluded that infrainguinal vein graft stenoses were successfully treated by single PTA. There was, however, a high restenosis rate after angioplasty of stenosis in the distal third of a vein graft and, while approximately one third of such stenoses can be treated by a single PTA, the optimal management of recurrent stenosis requires further investigation.