OBJECTIVES: The objectives of this study were to assess the impact of Duplex surveillance on the results of infrainguinal vein grafts. A review has been performed comparing the outcome of vein grafts undergoing Duplex surveillance plus prophylactic treatment of stenoses to that of vein grafts followed clinically. DESIGN, PATIENTS, AND METHODS: Only studies providing information on occlusion rates were included. Mortality and limb salvage rates were also analysed but were not available from all studies. RESULTS: 2680 surveillance and 3969 non-surveillance vein grafts were analysed. There was no significant difference between the two groups with respect to presence of critical ischaemia (p=0.3) and level of distal anastomosis (p>0.5). Surveillance identified 493 stenoses in 469 (19%) grafts, 397 (16%) grafts were treated by surgery (248; 62%) and angioplasty (149; 38%). Ninety-eight (26%) grafts developed recurrent stenoses. Total number of deaths, total number of occluded grafts and number of occlusions after 30 days were significantly greater for the non-surveillance group (p<0.001; p<0.001; p<0.01). Perioperative occlusion rates were not significantly different (p=0.1). Few surveillance studies reported limb salvage rates (6 of 17). The numbers of amputations were not significantly different between the two groups (p>0.5). CONCLUSIONS: The patency of infrainguinal vein grafts would appear to be improved as a result of surveillance. However, no improvement in limb salvage has been demonstrated.
OBJECTIVES: The objectives of this study were to assess the impact of Duplex surveillance on the results of infrainguinal vein grafts. A review has been performed comparing the outcome of vein grafts undergoing Duplex surveillance plus prophylactic treatment of stenoses to that of vein grafts followed clinically. DESIGN, PATIENTS, AND METHODS: Only studies providing information on occlusion rates were included. Mortality and limb salvage rates were also analysed but were not available from all studies. RESULTS: 2680 surveillance and 3969 non-surveillance vein grafts were analysed. There was no significant difference between the two groups with respect to presence of critical ischaemia (p=0.3) and level of distal anastomosis (p>0.5). Surveillance identified 493 stenoses in 469 (19%) grafts, 397 (16%) grafts were treated by surgery (248; 62%) and angioplasty (149; 38%). Ninety-eight (26%) grafts developed recurrent stenoses. Total number of deaths, total number of occluded grafts and number of occlusions after 30 days were significantly greater for the non-surveillance group (p<0.001; p<0.001; p<0.01). Perioperative occlusion rates were not significantly different (p=0.1). Few surveillance studies reported limb salvage rates (6 of 17). The numbers of amputations were not significantly different between the two groups (p>0.5). CONCLUSIONS: The patency of infrainguinal vein grafts would appear to be improved as a result of surveillance. However, no improvement in limb salvage has been demonstrated.
Authors: A Basile; D Tsetis; G Chlouverakis; G Calcara; G Ardita; G Giulietti; M Di Salvo; A Granata; T Lupattelli; M T Patti Journal: Radiol Med Date: 2008-06-03 Impact factor: 3.469
Authors: Giovanni Di Minno; Gaia Spadarella; Giovanni Cafaro; Maurizio Petitto; Roberta Lupoli; Alessandro Di Minno; Giovanni de Gaetano; Elena Tremoli Journal: Ann Med Date: 2014-07-21 Impact factor: 4.709
Authors: Manuel Hernando Rydings; Pilar Marín Palacios; Ana M Aragón-Sánchez; Esther Bravo Ruiz; Victor Lopez-Dominguez; Isaac Martínez López; Cristina Fernández Pérez; Amaia Bilbao González; Francisco Javier Serrano Hernando; Reyes Vega Manrique; Antonio Hernando Grande Journal: J Am Heart Assoc Date: 2016-07-22 Impact factor: 5.501