Jagadesham, VP, Snowdon, S, Weston, MJ et al. (1 more author) (2005) Intra-operative Doppler Flow Measurement do not Predict ‘At-risk’ Status of Infrainguinal Bypass Grafts. European Journal of Vascular and Endovascular Surgery, 30 (6). pp. 597-603. ISSN 1078-5884
Abstract
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 postoperative 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 Opdopw intra-operative Doppler machine. All grafts were determined to be technically adequate on the basis of measured peripheral resistance units (mPRU) being %1. At 1 week, a postoperative 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 (PZ0.19, 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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Doppler; ‘At-risk’; Infrainguinal; Grafts; Intraoperative |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Biological Sciences (Leeds) > School of Molecular and Cellular Biology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 06 Jun 2017 13:36 |
Last Modified: | 06 Jun 2017 13:36 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.ejvs.2005.04.048 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:117278 |