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A. J. Comerota, F. A. Weaver, J. D. Hosking, et al., “Results of a Prospective, Randomized Trial of Surgery versus Thrombolysis for Occluded Lower Extremity Bypass Grafts,” American Journal of Surgery, Vol. 172, No. 2, 1996, pp. 105-112. doi:10.1016/S0002-9610(96)00129-8

has been cited by the following article:

• TITLE: Operative or Interventional Treatment in Infrainguinal Bypass Occlusion: Are There Predictive Factors Affecting Outcome?

  AUTHORS: T. Betz, C. Uhl, M. Steinbauer, N. Zorger, I. Töpel

  KEYWORDS: Thrombolytic Therapy; Bypass occlusion; Percutaneous Intervention; Bypass Thrombectomy

  JOURNAL NAME: Surgical Science, Vol.3 No.10, October 18, 2012

  ABSTRACT: Purpose: To evaluate outcome of interventional and surcigal treatment in infrainguinal bypass occlusion and to identify predictive factors affecting therapeutic success. Material and Methods: Over a period of three years 96 patients with infrainguinal bypass occlusion were included in this retrospective study. 52 patients were treated by catheter-directed thrombolysis and 44 patients by reconstructive vascular surgery. Results: 41 grafts could be reopened in thrombolytic group (78.8%), thrombolysis failed in 11 cases (21.2%). 34 grafts were treated successfully by reconstructive vascular surgery (77.3%), 10 grafts couldn’t be reopened or reoccluded within 30 days after surcical therapy. After a median observation time of 14.7 months 30 of 48 (62.5%) bypass grafts treated with intraarterial thrombolysis and 19 of 27 (70.4%) grafts treated with thrombectomy were overall patent. Limb salvage was 81.3% in thrombolytic group and 88.8% in surgery group. No predictive factors affecting outcome could be identified in both groups except the localization of the occluded graft (above/below knee). Conclusion: Infrainguinal bypass occlusion is a serious and challenging complication in vascular surgery. Our study showed similar results for both therapeutic strategies. Despite our data was retrospective with a small number of patients the localization of the occluded graft as predictive pretherapeutic factor was significant in thrombolytic and surgery group. Based on these scientific findings we established a guideline for choice of therapeutic treatment in our institution after searching current literature.