ABSTRACT
Endovascular intervention is essential in the salvage of previous endovascular and open surgical reconstructions. The mechanisms of failure of previous reconstructions, whether open or endovascular, are similar. Drug-coated balloons, bare metal stents, stent-grafts, drug-eluting stents, and atherectomy may all be used at different times to salvage a previous endovascular reconstruction. The two approaches with the best data for reconstruction include either drug-coated balloon angioplasty or relining the occluded stent with a covered stent such as a Viabahn stent. Failing infrainguinal bypass grafts present a common application of endovascular intervention for salvage. Extra-anatomic bypass grafts, such as an axillofemoral graft or a femoral-femoral bypass graft, may be evaluated arteriographically by direct puncture and catheter placement or through entry into the native vasculature proximal or distal to the graft and cannulation with a catheter.
