Effectiveness of surveillance of infrainguinal grafts.
OBJECTIVE
To audit the surveillance programme of infrainguinal vein graft in a tertiary vascular unit, and find out how effective it was in preventing occlusion of grafts.


METHODS
Retrospective study.


METHODS
Teaching hospital, Scotland.


METHODS
59 consecutive patients who had 61 vein grafts between 1996 and 1998 for critical limb ischaemia.


METHODS
Grafts scanned at 3-monthly intervals for at least a year, and clinical review.


METHODS
Survival with an intact limb and patency of the graft.


RESULTS
52 of the 59 patients (90%) were alive at the time of follow up, and 55 of the 61 involved limbs (90%) were intact. Median follow up was 660 days (range 180-1995). 23 stenoses were detected by the surveillance programme. 17 grafts were revised, all of which were patent at follow up, and 8 other grafts occluded requiring 6 major amputations. One-year cumulative primary, primary-assisted, and secondary patency, and limb salvage rates were 63%, 88%, 88%, and 90% respectively.


CONCLUSIONS
Surveillance of infrainguinal grafts by duplex scanning is effective and has resulted in high rates of limb salvage and secondary patency in patients who presented with critical ischaemia.
Teo
N B
NB
Peripheral Vascular Unit, Royal Infirmary, Glasgow, Scotland, United Kingdom. teonb@hotmail.com
Mamode
N
N
Murtagh
A
A
Breslin
P
P
Pollock
J G
JG
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency; D014680:Veins / Q000637:transplantation*