title: Significance of the early postoperative duplex result in infrainguinal vein bypass surveillance.
abstract: BACKGROUND
  Duplex surveillance of infrainguinal vein grafts may not be efficient.
  
  
  METHODS
  Consecutive patients who had received infrainguinal vein grafts were enrolled in a duplex surveillance program. A first scan at 6 weeks after surgery categorized grafts into four groups: (a) low risk grafts, (b) mild flow disturbance, (c) intermediate stenosis and (d) critical stenosis. Disease progression was assessed over time.
  
  
  RESULTS
  Of 364 grafts followed-up for a median of 23 months, 236 (65%) had no flow abnormality at 6-weeks, and had a 40-month cumulative patency rate of 82%. The remaining 128 (35%) grafts had a flow disturbance. Of 29 critical stenoses, 15 were repaired, 11 occluded and three did not change. Of 57 intermediate lesions, 32 progressed to critical, nine occluded, two were repaired and 14 did not change or improved. Of 42 mild lesions, 16 progressed to a higher grade, four occluded and 22 did not change or improved. There was no significant difference in graft patency between grafts with repaired stenoses and those without stenoses, but grafts with untreated critical stenoses were associated with lower patency (p<0.001).
  
  
  CONCLUSIONS
  A duplex scan 6 weeks after operation can predict those patients who require continuing duplex surveillance.
authors.affiliation: Department of Vascular Surgery, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK. rmofidi@doctors.net.uk
authors.forename: R
authors.initials: R
authors.lastname: Mofidi
authors.forename: J
authors.initials: J
authors.lastname: Kelman
authors.forename: O
authors.initials: O
authors.lastname: Berry
authors.forename: S
authors.initials: S
authors.lastname: Bennett
authors.forename: J A
authors.initials: JA
authors.lastname: Murie
authors.forename: A R W
authors.initials: AR
authors.lastname: Dawson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D003251:Constriction, Pathologic; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D053208:Kaplan-Meier Estimate; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency; D014680:Veins / Q000000981:diagnostic imaging / Q000637:transplantation