DIRECTIONAL ATHERECTOMY IN THE TREATMENT OF ANASTOMOTIC NEOINTIMAL HYPERPLASIA ASSOCIATED WITH PROSTHETIC ARTERIAL GRAFTS - TECHNIQUE AND PRELIMINARY-RESULTS

The development of anastomotic neointimal hyperplasia is a common caus e of late prosthetic arterial bypass graft failure. The cost and morbi dity of graft failure are high, hence the widespread use of graft surv eillance programmes in order to detect graft-related stenoses before t hey progress to occlusion. However, the optimal treatment of stenoses secondary to neointimal hyperplasia is not clear, with a number of aut hors reporting poor results with both balloon angioplasty and surgical revision. We report our early experience with the Simpson atherectomy catheter in the treatment of anastomotic neointimal hyperplasia assoc iated with prosthetic arterial grafts at eight sites in seven patients . A high technical success rate may be expected and further long-term studies of this mode of treatment are indicated.