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Occluded infrainguinal reconstructions.

The causes of failure of infrainguinal arterial reconstruction vary with the method of reconstruction used. The commonest cause of autogenous vein-graft failure is myointimal hyperplasia of the graft itself. The commonest cause of polytetrafluoroethylene-graft failure, on the other hand, appears to be a myointimal hyperplastic lesion of the artery at, or just beyond, the distal anastomosis of the graft. Strategies for dealing with these two forms of graft failure, including the use of thrombolytic therapy, are discussed.