Preoperative prediction of graft patency for infrapopliteal arterial bypass using pulse-generated runoff.
OBJECTIVE
to assess: (i) pulse-generated runoff (PGR) as a tool for preoperative prediction of graft patency; (ii) the effect of PGR use on graft patency.


METHODS
retrospective analysis of continuous patient data.


METHODS
all patients undergoing bypass to the infrapopliteal vessels in the Oxford Regional Vascular Unit between 1989 and 1993.


METHODS
preoperative assessment using ankle-brachial indices, intra-arterial digital subtraction angiography and PGR. Six-monthly and then yearly clinical and duplex sonography follow-up to assess graft patency. Univariate analysis of graft patency to assess discriminatory ability of PGR for graft patency.


RESULTS
a biphasic signal in the artery of insertion was associated with significantly better graft patency rate at 1 month and at maximum follow-up than was a monophasic signal. A monophasic signal was associated with a 12-month patency of 25% and a mortality of 37.7%. Use of PGR did not affect graft patency significantly.


CONCLUSIONS
PGR is a useful, non-invasive, means of preoperative patient assessment to determine the potential for maintained graft patency.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D015901:Angiography, Digital Subtraction; D001795:Blood Pressure Determination; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000601:surgery; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011300:Preoperative Care; D011379:Prognosis; D011674:Pulse; D013997:Time Factors