A prospective comparison of ankle/brachial indices and color duplex imaging in surveillance of the in situ saphenous vein bypass.
We performed routine postoperative surveillance of 124 consecutive in situ saphenous vein bypasses, using both ankle-brachial indices and color flow duplex imaging. Using a combination of low and high velocity criteria, color flow duplex identified 97% (37/38) of bypass and native artery inflow stenoses subsequently demonstrated by angiography, including 20 of 21 severe stenoses. A reduction in ankle-brachial index by greater than 0.15 identified 43% (16/38) of all stenoses, and only 10 of 21 severe stenoses. Revisional operations were performed in 30 bypasses for abnormalities detected by surveillance, resulting in a 3-year cumulative secondary patency of 87%. Color flow duplex is a superior technique for in situ bypass surveillance when compared to alterations in ankle-brachial indices. The identification of a bypass or inflow stenosis by routine surveillance and its subsequent operative treatment result in satisfactory long-term patency.
Laborde
A L
AL
University of Iowa Hospitals and Clinic, Iowa City.
Synn
A Y
AY
Worsey
M J
MJ
Bower
T R
TR
Hoballah
J J
JJ
Sharp
W J
WJ
Kresowik
T F
TF
Corson
J D
JD
D000368:Aged; D000792:Angiography; D000842:Ankle / Q000098:blood supply / Q000503:physiopathology*; D001132:Arm / Q000098:blood supply / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D003116:Color; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012086:Reoperation; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D013599:Systole; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D014463:Ultrasonography