Femorodistal vein grafts: The utility of graft surveillance criteria

Michael C. Dalsing, Dolores F. Cikrit, Stephen G. Lalka, Alan P. Sawchuk, Catherine Schulz

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Purpose: This retrospective review of femorodistal vein grafts was analyzed to determine the usefulness of various graft surveillance criteria. Method: The surveillance schedule involved evaluations at 1 month, every 3 months the first year, and then every 6 months. Salvage intervention or graft occlusion occurring within the next follow-up interval defined surveillance end points. One hundred two grafts (329 surveillance visits) had an ankle/brachial index (ABI). A duplex scanning - determined midgraft peak systolic flow velocity (PSFV) was available for 81 grafts (262 visits). Forty-eight grafts (137 visits) had both a PSFV and entire graft duplex scanning (EGDS) to determine stenosis greater than 50%, whereas 40 grafts (91 visits) had simultaneous ABI and EGDS. Results: When a greater than 15% decrease in ABI denoted an abnormal surveillance study result, a positive predictive value (PPV) of 24.3% and negative predictive value of 94.5% were noted. Similarly, a PSFV cutoff of less than 35 cm/sec demonstrated values of 26.3% and 94.2%, respectively. When an EGDS of greater than 50% stenosis or a PSFV of less than 35 cm/sec were the cutoff criteria, the PPV was 36.7% and negative predictive value 99.1%, whereas characterizing abnormal results further with ABI (>15%↓) increased the PPV to 83.3%. Conclusion: The combination of an EGDS, midgraft PSFV, and ABI provides optimal follow-up for our patients with a femorodistal vein graft. (J V ASC S URG 1995; 21:127-34.).

Original languageEnglish (US)
Pages (from-to)127-134
Number of pages8
JournalJournal of vascular surgery
Volume21
Issue number1
DOIs
StatePublished - Jan 1995
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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