Heterogeneous and dynamic lumen remodeling of the entire infrainguinal vein bypass grafts in patients

摘要: Abstract Objective To examine the regional variation and temporal change in lumen size along entire autogenous vein bypass graft used for treating arterial occlusive disease lower extremity to explore factors associated with expansive or constrictive remodeling. Methods Patients were prospectively scanned using contrast-enhanced computed tomography at 1 week 1, 6, 12 months postoperatively obtain cross-sectional areas 1-mm intervals grafts. Graft remodeling characteristics demographic clinical examined. Results Fifty-six patients least two consecutive scans analyzed. a composite longer graft, diabetes, had larger area graft. The mean of all grafts demonstrated no significant changes through 12 months. However, individually, was time dependent there more dramatic within first postoperative month. At 12 months, near equal distribution between existed. A negative relation initial diameters subsequent diameter observed. Eleven failed 12 months; patent similar four points, but maximal local reduction from 1 month (58.0 ± 6.7% vs 38.1 ± 3.1%, mean ± standard error mean, patent, P = .004). Black smaller than white points also higher early percent (−20.5 ± 6.3% −1.0 ± 3.7%, black white, .018). Cilostazol use Conclusions Vein remodel heterogeneously dynamically. Remodeling is size, race, cilostazol use. It found that produces some critical minimum during month may predispose failure. These findings offer insight into further investigation underlying mechanisms opportunities improve durability.