Impact of a color-flow duplex surveillance program on infrainguinal vein graft patency: A five-year experience Mirza M. Idu, MD, Jan D. Blankstein, MD,

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Presentation transcript:

Impact of a color-flow duplex surveillance program on infrainguinal vein graft patency: A five-year experience Mirza M. Idu, MD, Jan D. Blankstein, MD, PhD, Peter de Gier, MD, Elly Truyen, RVT, Jacob Buth, MD, PhD Journal of Vascular Surgery Volume 17, Issue 1, Pages 42-53 (January 1993) DOI: 10.1016/0741-5214(93)90008-A Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Intraarterial DSA (center) of femoroperoneal vein graft with 90% DR stenosis (arrow) and Doppler flow velocity spectra at first surveillance visit 6 weeks after operation. PSV (top), EDV (middle), and average velocity (bottom) are shown in tracings. A, Proximal of stenosis. Normal velocity spectrum with PSV of 64 cm/sec. B, At stenosis. PSV increased to 482 cm/sec and EDV to 127 cm/sec, typical for stenotic changes. C, Distal from stenosis. Still broadened velocity spectrum with PSV of 125 cm/sec. Journal of Vascular Surgery 1993 17, 42-53DOI: (10.1016/0741-5214(93)90008-A) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Intraarterial DSA (center) of femoroanterotibial vein graft with severe distal anastomotic stenosis (arrows) and flow velocity spectrum tracings at 15 weeks after operation. PSV (top), EDV (middle), and average velocity (bottom) are shown in tracings. A, Proximal of stenosis. PSV is abnormally low at 35 cm/sec (values <45 cm/sec indicate grafts at risk27). B, At stenosis. PSV increased to 413 cm/sec. C, Anterior tibial artery. Low PSV of 23 cm/sec. At examination 6 weeks earlier, normal PSV values of 56 to 73 cm/sec were observed at these three sites. Journal of Vascular Surgery 1993 17, 42-53DOI: (10.1016/0741-5214(93)90008-A) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Correlation of PSV index in vein grafts with and without graft stenosis. Mean PSV index is 0.41 ± 0.22 (SD) for stenotic grafts and 0.97 ± 0.24 (SD) for normal grafts, p < 0.0001. Journal of Vascular Surgery 1993 17, 42-53DOI: (10.1016/0741-5214(93)90008-A) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Cumulative primary rates in grafts that undergo color-flow (CF) surveillance and in grafts that undergo clinical follow-up. Numbers at different intervals are represented. Journal of Vascular Surgery 1993 17, 42-53DOI: (10.1016/0741-5214(93)90008-A) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Cumulative assisted primary patency rates in grafts that undergo color-flow (CF) surveillance and in grafts that undergo clinical follow-up. Journal of Vascular Surgery 1993 17, 42-53DOI: (10.1016/0741-5214(93)90008-A) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions