Catharina Hospital 152 PUBLICATIONS 7,780 CITATIONS

Objectives: To investigate the effectiveness of two alternative vein-graft surveillance strategies. In the first strategy surveillance was restricted to patients with a possible higher risk of significant stenosis development, i.e. those with a moderate stenosis identified early after the operation. In the second strategy the effects of reducing the number of duplex tests per patient was examined. Patients and Methods: In a prospective study in three vascular surgical departments 300 patients (300 femoropopliteal or distal grafts) underwent duplex surveillance during the first year after the operation. The duplex-derived PSV-ratio was considered to represent he degree of stenosis. Arteriographic confirmation of suspected stenoses was routinely obtained, and patients without a suspected graft stenosis underwent a consented arteriogram during the first postoperative year. The decision to petform ag'aft revision was taken on the basis of an arteriographic stenosis of at least 70 % diameter reduction. In the fi'rst strategy graft categories were defined on the basis of the first postoperative duplex examination: grafts with a PSV-ratio <1.5, grafts with a PSV-ratio <1.5-2.0, grafts with a PSV-ratio of 2.0-2.5, grafts with PSV-ratios 2.5-3.0, and grafts with PSV-ratios>3.0. The primary patency rate at 12 months was compared for these categories. In the second alternative strategy the number of examinations and the percentage of event causing de novo stenose