DUPLEX ASSESSMENT OF RUN-OFF BEFORE FEMOROCRURAL RECONSTRUCTION

Background This study was a prospective evaluation of colour duplex im aging for the assessment of distal run-off before femorocrural reconst ruction. Methods Patients with critical ischaemia who required a dista l bypass underwent preoperative run-off assessments using dependent Do ppler, arteriography and duplex imaging by a vascular surgeon, radiolo gist and technologist respectively; each was blinded to the findings o f the others. Preoperative data were compared with intraoperative clin ical findings and completion flow studies/arteriograms. Results Forty- three consecutive patients (33 men, ten women; mean age 78 (range 53-9 5) years; 12 diabetic) undergoing 34 femorocrural reconstructions for critical ischaemia were assessed. The 30-day primary cumulative graft patency for the series was 86 per cent. Dependent Doppler correctly pr edicted a suitable run-off vessel in 21 limbs but was indeterminate in four and unrecordable in 19. Arteriography correctly predicted a suit able run-off vessel in 32 cases, but was indeterminate in six and fail ed to demonstrate run-off in three patients. Arteriography suggested a n inferior vessel in three cases. Duplex correctly predicted a suitabl e run-off vessel for all 34 grafts. Conclusion Duplex imaging is super ior to arteriography for preoperative assessment of distal run-off for femorocrural reconstruction.