The progression and correction of duplex detected velocity shifts in angiographically normal vein grafts.
OBJECTIVE
To review the sensitivity of duplex scanning and angiography at detecting vein graft stenoses in patients on a graft surveillance programme.


METHODS
Prospective, open, non-randomised study.


METHODS
Since February 1993, 143 patients with 148 grafts (70% in situ, 30% reversed) have attended postoperative infrainguinal vein graft surveillance for a minimum of 6 weeks. Fifty-seven graft stenoses in 57 grafts were identified by duplex scanning as a localised high velocity jet. Angiography was performed in all except 12 patients.


RESULTS
Angiography confirmed a duplex abnormality in all but 10 patients. Of these, five patients remain stable and asymptomatic with a persisting duplex abnormality. The remaining five patients, although asymptomatic, exhibited disease progression on duplex and surgical intervention confirmed significant stenoses, which were successfully treated.


CONCLUSIONS
The results suggest that duplex scanning is a reliable imaging modality for detecting vein graft stenoses. Selection for surgical correction can be made, in some circumstances on the basis of clinical and ultrasound criteria alone.
Lewis
D R
DR
Department of Surgery, Bristol Royal Infirmary, U.K.
McGrath
C
C
Irvine
C D
CD
Jones
A
A
Murphy
P
P
Smith
F C
FC
Baird
R N
RN
Lamont
P M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D015901:Angiography, Digital Subtraction; D001783:Blood Flow Velocity / Q000502:physiology; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex; D014680:Veins / Q000000981:diagnostic imaging / Q000502:physiology / Q000637:transplantation*