| Intra-operative Doppler flow measurement do not predict 'at-risk' status of infrainguinal bypass grafts. | |
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MedLine Citation:
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PMID: 16054850 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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V P Jagadesham; S Snowdon; M J Weston; P J Kent |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2005-07-28 |
Journal Detail:
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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:
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Created Date: 2005-11-30 Completed Date: 2006-01-12 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 597-603 Citation Subset: IM |
Affiliation:
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Department of Vascular and Endovascular Surgery, St James' University Hospital, Lincoln Wing, Leeds LS9 7TF, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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