LONG-TERM ANGIOGRAPHIC FOLLOW-UP OF OCCLUDED SAPHENOUS BYPASS GRAFTS TREATED WITH PROLONGED UROKINASE INFUSION

We report on 10 occluded saphenous vein bypass grafts in nine patients treated with prolonged urokinase infusion. Our purpose was to evaluat e the patency of these grafts during long-term follow-up, We retrospec tively analyzed consecutive patients treated at a single center. All p atients had angiography 0.25 to 54 months after treatment. Results ind icated that clot lysis was achieved in all grafts with urokinase infus ions of 1,790,000 to 25,920,000 units given over 17 to 108 hours. In t wo grafts there was no filling of the distal native vessel and in one, a 50% stenosis with ulceration remained. There was a progressive loss of graft patency over the first 18 months, but 50% of the grafts that were opened with prolonged urokinase infusion remain patent, Long-ter m patency depends upon successful opening without residual obstruction and with good flow into the distal native vessel. (C) 1998 Wiley-Liss , Inc.