Comparison of infrainguinal graft surveillance techniques

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Presentation transcript:

Comparison of infrainguinal graft surveillance techniques Richard M. Green, MD, FACS, Joanne McNamara, RN, MS, Kenneth Ouriel, MD, James A. DeWeese, MD, FACS Journal of Vascular Surgery Volume 11, Issue 2, Pages 207-215 (February 1990) DOI: 10.1016/0741-5214(90)90263-A Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A life-table comparison of primary and secondary patency rates. These curves represent grafts that were revised only for thrombosis or recurrent symptoms. Journal of Vascular Surgery 1990 11, 207-215DOI: (10.1016/0741-5214(90)90263-A) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 The fate of an abnormal ABI (>0.10 decrease). An abnormal ABI in the absence of symptoms prompted a decrease in the surveillance interval to 3 months. The abnormality persisted in 26 patients. No further diagnostic tests (No dx) were done in six patients and three grafts failed before the next visit (No dx/Thromb). Angiograms were obtained for 20 patients in whom symptoms developed. Correctable lesions (Angio/Rx) were identified and fixed in eight patients, normal grafts were identified in three patients (Angio/OK), graft thromboses were seen in five patients (Angio/Thromb), and inoperable outflow lesions were seen in four patients (Angio/inop). Journal of Vascular Surgery 1990 11, 207-215DOI: (10.1016/0741-5214(90)90263-A) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Conditional probabilities for the tests with stated norms. The sensitivity (SENS) or the probability that a graft about to occlude will yield a positive test was highest for the duplex scan with or without the ABI. The specificity (SPEC) or the probability that a nonthreatened graft will test normally was highest when both the duplex and the ABI were normal. The predictive value of an abnormal test (PPV) was highest for the combination of an abnormal duplex and ABI. The predictive value of a negative test (NPV) was similar for all the tests. Journal of Vascular Surgery 1990 11, 207-215DOI: (10.1016/0741-5214(90)90263-A) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions