Document Detail


Intra-operative Doppler flow measurement do not predict 'at-risk' status of infrainguinal bypass grafts.
MedLine Citation:
PMID:  16054850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Patients undergoing infrainguinal arterial reconstruction using vein conduits, frequently undergo intra-operative Doppler flow measurements to determine technical adequacy. The aim of this study was to determine the proportion of vein grafts with normal intra-operative haemodynamic parameters that were subsequently discovered to be 'at risk' on post-operative duplex surveillance scanning. METHODS: We prospectively collected data on 82, primary infrainguinal vein bypass grafts. Post papaverine graft flow and peripheral resistance were measured using the Scimed Opdop intra-operative Doppler machine. All grafts were determined to be technically adequate on the basis of measured peripheral resistance units (mPRU) being < or =1. At 1 week, a post-operative duplex surveillance scan was performed. At risk status was determined and compared to the intra-operative Doppler flow measurement. Statistical analysis was performed using the Mann-Whitney U-test. RESULTS: The post-operative duplex scan demonstrated that 53 (65%) of the 82 vein bypass grafts were diagnosed as being 'not at risk'; and 29 (35%) were regarded as at risk. When the groups were compared, there was no significant difference in intra-operative haemodynamic parameters between those not at risk and those at risk (P=0.19, Mann-Whitney U-test). The 1 month primary patency rate was 79% with a secondary patency rate of 100%. CONCLUSION: Despite normal intra-operative Doppler flow measurements, 35% of vein grafts were regarded as being at risk at the 1 week post-operative duplex surveillance scan. No single value may be universally applicable for identifying at risk grafts intraoperatively. Indeed, graft failure appears to be a multifactorial process.
Authors:
V P Jagadesham; S Snowdon; M J Weston; P J Kent
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-07-28
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  30     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-30     Completed Date:  2006-01-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  597-603     Citation Subset:  IM    
Affiliation:
Department of Vascular and Endovascular Surgery, St James' University Hospital, Lincoln Wing, Leeds LS9 7TF, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arterial Occlusive Diseases / physiopathology*,  surgery,  ultrasonography
Blood Flow Velocity
Blood Vessel Prosthesis*
Female
Follow-Up Studies
Humans
Inguinal Canal / blood supply*
Male
Middle Aged
Monitoring, Intraoperative / methods*
Popliteal Artery / surgery,  ultrasonography
Prospective Studies
Reproducibility of Results
Risk Factors
Saphenous Vein / transplantation*
Treatment Outcome
Ultrasonography, Doppler, Duplex*
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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