[Occlusion of aorto-femoral vascular prostheses after long-term implantation]. / Uzáverky cévních protéz dlouhodobe implantovaných v aorto-femorálním tepenném úseku.

The authors present a report dealing with their experience with reoperations for occlusion of vascular prostheses implanted in aorto-femoral region in the late postoperative period. The most frequent cause of this occlusions was the obstruction of the outflow track at the distal anastomosis. In small arteries (under 5 mm) this obstruction was mainly caused by myointimal proliferation which originated from the host artery. In the early period after occlusion it is possible to remove the thrombus from the prostheses mostly in all patients by means of Fogarty catheter and to ensure the long lasting passage of the prostheses by plastic operations of the origin of profunda femoral artery. In long lasting occlusions of the prostheses can thrombolytic therapy 1-2 weeks before reoperation facilitate removing of the thrombus. In 113 patients with the different type of reoperations for occlusion of the prostheses in the aorto-femoral region we succeeded in 102 patients (90.3%). In 8 patients the reoperation was not successful (7%) and we had to amputate the distal extremity and three patients (2.3%) died from the heart complications in the early postoperative period.