Critical Assessment of the Outcome of Infrainguinal Vein Bypass

Golledge, Jonathan; Iannos, J.; Walsh, John; Burnett, Jim; Foreman, Robert K.

doi:10.1097/00000658-200111000-00017

Cited by 16 publications

(13 citation statements)

References 9 publications

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“…Our overall 1-year secondary patency rate was 77% and is comparable to what is reported in the literature. [18][19][20] However, secondary patency rates of 90% have been reported in studies using intraoperative duplex scanning and revisions. 2,10 It needs to be proven whether revision of the lesions as detected by means of intraoperative duplex scanning will in the long run result in improvement of the secondary patency rate in the patient population at this institution.…”

Section: Discussionmentioning

confidence: 99%

The Fate of Unrevised Stenoses in Infrainguinal Autologous Vein Grafts as Detected by Intraoperative Duplex Scanning

Idu¹,

Ubbink²,

Legemate³

2005

Vasc Endovascular Surg

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Intraoperative infrainguinal autologous vein graft stenoses are common, and some authors advise revision of these stenoses. But the natural history of these lesions is not clear. This study was undertaken to determine the natural history of duplex-detected intraoperative stenoses with a nonrevision policy. Intraoperative duplex scanning was performed in 46 infrainguinal autologous vein bypasses. The surgeon was blinded for the results of the intraoperative duplex scan and no intraoperative graft revision or modification of the routine postoperative protocol was performed after the duplex scan. Intraoperative duplex parameters and patient and bypass characteristics were correlated with the occurrence of an early graft event (occlusion or revision of a patent graft within 6 weeks postoperatively), which was the study's primary endpoint. Early graft event rate was 37% (17/46). PSV ratio and PSV-max were the only parameters with a significant correlation with the occurrence of an early graft event. An intraoperatively measured PSV ratio of > or =3.0 was the best predictor of an early graft failure with a sensitivity of 71% (95% CI: 50-83%) and a specificity of 90% (95% CI: 78-97%). In 12 of the 15 (80%) grafts matching this criterion an early graft event occurred, while only 5 (16%) early graft events occurred in the remaining 31 grafts (ie, a negative predictive value of 84%). When a PSV ratio of > or =3.0 was used as a cutoff value to predict early postoperative graft events, the likelihood ratios for a positive and negative test result were respectively 6.82 (95% CI: 2.23-20.8) and 0.33 (95% CI: 0.16-0.69). Unrevised intraoperative duplex-detected stenoses in infrainguinal autologous vein graft stenoses are a serious threat to early graft patency. The presence of an intraoperatively detected graft stenosis with a PSV ratio > or =3.0 is a strong predictor of early graft failure.

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Section: Discussionmentioning

confidence: 99%

The Fate of Unrevised Stenoses in Infrainguinal Autologous Vein Grafts as Detected by Intraoperative Duplex Scanning

Idu¹,

Ubbink²,

Legemate³

2005

Vasc Endovascular Surg

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“…Between August 1993 and 1999, 236 patients underwent primary infra‐inguinal vein bypass at The Repatriation General Hospital, Adelaide 13 . The indications for surgery were popliteal aneurysm ( n = 5), intermittent claudication ( n = 92), rest pain ( n = 48), ischaemic ulceration ( n = 53), gangrene ( n = 23) or acute ischaemia ( n = 15).…”

Section: Methodsmentioning

confidence: 99%

“…A completion angiogram was obtained in all patients. Following surgery patients were entered into a duplex surveillance programme 13 . Primary and secondary patency was reported in line with The Society of Vascular Surgery standards 14 .…”

Section: Methodsmentioning

confidence: 99%

“…Primary and secondary patency was reported in line with The Society of Vascular Surgery standards 14 . In addition outcome at 12 months was defined as ideal if there was a patent graft, no perioperative complication, no further intervention, no related readmission and the patient was alive 13 . Analysis of graft outcome was performed using a combination of univariate (χ 2 ), multiple logistic regression analysis and Kaplan−Meier analysis with log rank test.…”

Section: Methodsmentioning

confidence: 99%

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Arterial flow induces changes in venous endothelium which are modified by calcium channel blockers

Golledge

2004

ANZ Journal of Surgery

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“…Шунтирование не показано 54% больных КИНК в связи с распространенным характером поражения артерий, а у 7% больных невыполнимо в связи с тяже-лой сопутствующей патологией [42]. При этом «идеальный результат» операции достигается лишь у 14-22% больных [43,44].…”

Section: Modern Possibilities To Predict Surgical Outcomes In Patientunclassified

Modern possibilities to predict surgical outcomes in patients with chronic lower limb ischemia

Гавриленко¹,

Gavrilenko²,

Al-Yousef³

2017

Kardiol. serdechno-sosud. khir.

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Critical Assessment of the Outcome of Infrainguinal Vein Bypass

Cited by 16 publications

References 9 publications

The Fate of Unrevised Stenoses in Infrainguinal Autologous Vein Grafts as Detected by Intraoperative Duplex Scanning

The Fate of Unrevised Stenoses in Infrainguinal Autologous Vein Grafts as Detected by Intraoperative Duplex Scanning

Arterial flow induces changes in venous endothelium which are modified by calcium channel blockers

Modern possibilities to predict surgical outcomes in patients with chronic lower limb ischemia

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