title: Femorodistal vein grafts: the utility of graft surveillance criteria.
abstract: OBJECTIVE
  This retrospective review of femorodistal vein grafts was analyzed to determine the usefulness of various graft surveillance criteria.
  
  
  METHODS
  The surveillance schedule involved evaluations at 1 month, every 3 months the first year, and then every 6 months. Salvage intervention or graft occlusion occurring within the next follow-up interval defined surveillance end points. One hundred two grafts (329 surveillance visits) had an ankle/brachial index (ABI). A duplex scanning-determined midgraft peak systolic flow velocity (PSFV) was available for 81 grafts (262 visits). Forty-eight grafts (137 visits) had both a PSFV and entire graft duplex scanning (EGDS) to determine stenosis greater than 50%, whereas 40 grafts (91 visits) had simultaneous ABI and EGDS.
  
  
  RESULTS
  When a greater than 15% decrease in ABI denoted an abnormal surveillance study result, a positive predictive value (PPV) of 24.3% and negative predictive value of 94.5% were noted. Similarly, a PSFV cutoff of less than 35 cm/sec demonstrated values of 26.3% and 94.2%, respectively. When an EGDS of greater than 50% stenosis or a PSFV of less than 35 cm/sec were the cutoff criteria, the PPV was 36.7% and negative predictive value 99.1%, whereas characterizing abnormal results further with ABI (> 15% decreases) increased the PPV to 83.3%.
  
  
  CONCLUSIONS
  The combination of an EGDS, midgraft PSFV, and ABI provides optimal follow-up for our patients with a femorodistal vein graft.
authors: Indiana University Medical Center, Indianapolis 46202.
authors: M C
authors: MC
authors: Dalsing
authors: D F
authors: DF
authors: Cikrit
authors: S G
authors: SG
authors: Lalka
authors: A P
authors: AP
authors: Sawchuk
authors: C
authors: C
authors: Schulz
mesh_terms: D000842:Ankle / Q000098:blood supply; D001783:Blood Flow Velocity; D001794:Blood Pressure; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014680:Veins / Q000637:transplantation