The "ad hoc" estimation of outflow does not predict patency of infrainguinal reconstructions.
OBJECTIVE
This prospective study was performed to evaluate the clinical implication of the adhoc estimation (also called SVS score) of outflow on patency of infrainguinal in situ femoropopliteal or -distal bypasses.


METHODS
The bypasses were followed with Duplex scanning at 1, 3, 6, and 12 months after surgery. Fifty-three bypasses were recruited for the study, 20 of which were performed in 17 diabetics. In 47% the adhoc scoring was < or = 4.5 and in 53% it was between 5 and 10 (1 corresponds to an excellent outflow and 10 to a blind segment).


RESULTS
Within the first 30 days eight occlusions occurred, all of which were surgically corrected. The adhoc score for these bypasses was 4.2 vs. 4.9 (NS) for those who did not occlude. During follow-up, revisions were performed in 21 cases (40%) with 30 interventions. At the end of 1 year, 68% of the bypasses were patent (80% among diabetics and 64% among non-diabetics, NS). Patency at 1 year was not influenced by the adhoc classification.


CONCLUSIONS
The estimation of outflow from angiography seems to be of no value in predicting graft patency in infrainguinal grafting.
Takolander
R
R
Dept. Surgery, Karolinska Hospital, Stockholm, Sweden.
Fischer-Colbrie
W
W
Jogestrand
T
T
Ohlsén
H
H
Olofsson
P
P
Swedenborg
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D003925:Diabetic Angiopathies / Q000601:surgery; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014654:Vascular Patency