Surgical Management of Arterial Restenosis

Suh, Bo Yang

Abstract

The number of procedures performed annually for occlusive vascular disease continues to increase. Currently, approximately 500,000 patients undergo reconstructive vascular surgery each year; half of these procedures are coronary bypass procedures and the remainder include various operations on the peripheral vascular tree. These peripheral interventions encompass a wide assortment of procedures including autogenous and prosthetic bypass grafts, endarterectomies, and a variety of new endovascular procedures. Most established vascular procedures, as well as the new technologies and applications, have proven both technically feasible and safe. The value of any surgical procedure must be measured not only by the success by which it can be initially performed but also in terms of the durability of the results. Although in-hospital success rates are excellent, the long-term durability of most of these procedures has been disappointing. Furthermore, the common culprit accounting for much of the poor long-term success rate of these procedures is intimal hyperplasia. Clearly this process is a significant cause of morbidity in patients undergoing procedures on the vascular system, and investgations into methods to prevent or reverse this process are of great importance. Author evaluates incidence, cause and treatment procedures to correct restenosis and analyzes the results of these procedures in the fields of restenosis after peripheral bypass, carotid endarterectomy and endovascular surgery.