Magee GA, Plotkin A, Yi JA, Bowser KE, Kuwayama DP. Successful use of continuous vasodilator infusion to treat critical vasospasm threatening a distal bypass.
JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2018;
4:58-62. [PMID:
29725664 PMCID:
PMC5928283 DOI:
10.1016/j.jvscit.2017.12.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022]
Abstract
Vasospasm immediately after lower extremity arterial bypass may represent an uncommon cause of early graft failure. We report a successful case of catheter-directed, intra-arterial continuous vasodilator infusion to salvage a bypass graft threatened by severe, refractory vasospasm after incomplete response to nicardipine, verapamil, and nitroglycerin boluses. A continuous nitroglycerin infusion was administered for 24 hours, by which time the vasospasm resolved. At 12 months postoperatively, the graft remained patent with normal results of vascular laboratory studies. This report demonstrates that in cases of refractory vasospasm after peripheral bypass, continuous vasodilator infusion can be an effective treatment to prevent early graft failure.
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