Lower-extremity vascular grafts placed for peripheral vascular disease: prospective evaluation with duplex Doppler sonography.
Eighty-five men with 92 vascular grafts placed for peripheral vascular disease of the lower extremity underwent a total of 264 examinations with duplex Doppler over a 2.5-year period. In 64 patients who underwent more than one examination, the total follow-up encompassed 740 months. In 220 native femoral arteries (96.0%) the peak systolic velocity (PSV) was higher than that in the graft. Arteriovenous shunting was associated with a normal PSV and a markedly elevated diastolic component at spectral analysis. Focal fluid collections were common initially near the graft and usually disappeared uneventfully. An average PSV of 32 cm/sec or less was always associated with impending occlusion. The sensitivity of an average PSV of 40 cm/sec or less to indicate impending graft occlusion by the next visit was only 33%; the specificity, 94%. At initial examination, stenoses were associated with high PSV focally in the graft or low PSV with absent diastolic flow.
Gooding
G A
GA
Department of Radiology, San Francisco Veterans Administration Medical Center, CA 94121.
Perez
S
S
Rapp
J H
JH
Krupski
W C
WC
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000637:transplantation*; D004301:Doppler Effect; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D011446:Prospective Studies; D013599:Systole; D013848:Thigh / Q000098:blood supply; D014463:Ultrasonography; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D014654:Vascular Patency