E. John Harris Jr.

Publication Details

  • THE IMPORTANCE OF ROUTINE SURVEILLANCE OF DISTAL BYPASS GRAFTS WITH DUPLEX SCANNING - A STUDY OF 379 REVERSED VEIN GRAFTS Mills, J. L., Harris, E. J., Taylor, L. M., BECKETT, W. C., Porter, J. M. MOSBY-YEAR BOOK INC. 1990: 379-389

    Abstract:

    To assess the utility of routine duplex surveillance, 379 infrainguinal reversed vein grafts performed at two independent teaching hospitals were prospectively entered into a surveillance protocol from March 1986 through August 1989. An average of 3.2 postoperative duplex graft flow velocity (GFV) measurements per graft was obtained during a mean follow-up interval of 21 1/2 months. Only 2.1% of 280 grafts with GFV measurements greater than 45 cm/sec failed within 6 months of a normal surveillance examination. GFV measurements less than 45 cm/sec in 99 grafts led to arteriography in 75 grafts, identifying 50 stenotic lesions in 48 bypasses (12.6% of series). Inflow lesions were present in 5%, outflow stenoses in 2%, and intrinsic graft stenoses in only 6% of bypasses. Only 29% of grafts identified as failing by duplex scan were associated with a reduction in ankle-brachial index of greater than 0.15. Secondary reconstructions were performed in 48 grafts based on detection of a reduced GFV measurement; all such reconstructions are patent after a mean follow-up of 5 months. Duplex surveillance is more reliable in identification of failing vein grafts than is determination of ankle-brachial index.

    View details for Web of Science ID A1990EE58200001

    View details for PubMedID 2214034

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