title: Stenosis of reverse great saphenous vein graft in infrainguinal arterial revascularization.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prevalence of hemodynamically significant infrainguinal bypasses stenosis using reverse great saphenous vein graft.
  
  
  METHODS
  From March of 2008 to March of 2009, 56 infrainguinal bypasses were performed with reverse great saphenous vein graft in 56 patients. On the 30th post-operative day, 32 out of 56 patients were submitted to vascular ultrasonography. The prevalence of significant graft stenosis was determined. In addition, the diagnosis of stenosis was related to the clinical and surgical characteristics of the patients. The variables analyzed at the moment of diagnosis were the localization of the graft stenosis, the risk factors associated with stenosis and the association of vascular ultrasonography findings with ankle brachial pressure index (ABI).
  
  
  RESULTS
  The overall prevalence of significant graft stenosis was 48.4%. Out of the total number of observed stenosis, 19.4% were considered severe, and 29% mild or moderate. There was no significant association between the presence of significant stenosis and the following variables: gender, diabetes, hypertension, smoking, hipercholesterolemia, graft diameter, site of the distal anastomosis, and graft composition. There was a weak agreement between ABI and vascular ultrasonography in detecting stenosis in general (K = 0.30; CL95% 0.232 - 0.473; p = 0.018). However, there was a substantial agreement in detecting severe stenosis (K = 0.75; CL95% 0.655 - 0.811; p = 0.0001).
  
  
  CONCLUSIONS
  There was a high prevalence of stenosis on the 30th post-operative day, mostly localized in the proximal half of the vein graft. There was no significant association of stenosis with clinical and surgical factors analyzed. ABI and vascular ultrasonography had weak agreement with the diagnosis of stenosis in general and an important agreement for the diagnosis of severe stenosis.
authors.affiliation: Universidade Federal de Minas Gerais – UFMG, Belo Horizonte, MG, Brazil. petronio@sbccv.org.br
authors.forename: Francesco Evangelista
authors.initials: FE
authors.lastname: Botelho
authors.forename: Tarcizo Afonso
authors.initials: TA
authors.lastname: Nunes
authors.forename: Túlio Pinho
authors.initials: TP
authors.lastname: Navarro
authors.forename: Bruno Lima de
authors.initials: BL
authors.lastname: Castro
authors.forename: Daniel Lopes
authors.initials: DL
authors.lastname: Pinheiro
authors.forename: Jose Oyama Moura
authors.initials: JO
authors.lastname: Leite
authors.forename: Petronio Generoso
authors.initials: PG
authors.lastname: Thomaz
authors.forename: Renato Samy
authors.initials: RS
authors.lastname: Assad
mesh_terms: D055109:Ankle Brachial Index; D001158:Arteries; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D018616:Ultrasonography, Doppler, Duplex