Does a completely accomplished duplex-based surveillance prevent vein-graft failure?
OBJECTIVE
to assess the benefits of duplex-based vein-graft surveillance over clinical surveillance with distal pressure measurements.


METHODS
prospective randomised comparative trial.


METHODS
three hundred and forty-four patients with 362 consecutive infrainguinal vein bypasses were prospectively randomised to a follow-up regime with or without duplex scanning (ABI group and DD group) at 1, 3, 6, 9, and 12 months postoperatively.


RESULTS
one hundred and eighty-three grafts were enrolled to the ABI group and 179 to the DD group. The primary assisted patency, secondary patency and limb salvage rates were 67%, 74%, 85% for the ABI group and 67%, 73%, 81% for the DD group. Ninety grafts in the ABI group and 57 in the DD group had surveillance that completely adhered to the protocol. The outcome was also similar for these groups at one year (77%, 87%, 94% and 77%, 83%, 93% respectively), although grafts were revised more frequently in the DD group.


CONCLUSIONS
intensive surveillance with duplex scanning did not improve the results of any outcome criteria examined. To demonstrate any potential benefit of duplex scanning for vein-graft surveillance a multicentre study with a large number of patients to ensure sufficient power is needed.
Ihlberg
L
L
Division of Vascular Surgery, Department of Surgery, Helsinki, Finland.
Luther
M
M
Albäck
A
A
Kantonen
I
I
Lepäntalo
M
M
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000517:prevention & control; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011446:Prospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014680:Veins / Q000000981:diagnostic imaging* / Q000637:transplantation*