ONE-POINT MEASUREMENT OF THE PEAK-TO-PEAK PULSATILITY INDEX AS AN INDICATOR FOR EVALUATION OF INFRAINGUINAL BYPASS PROCEDURES

While duplex scanning has been advocated as the most accurate modality for postoperative graft surveillance, it is time-consuming for evalua ting the entire graft. The aim of the present study was to determine w hich parameter predicts graft failure most simply and precisely, by ex amining 62 men and 1 woman who collectively underwent 71 infrainguinal arterial bypasses. A total of 212 scannings were obtained using a dup lex scanner, and the peak systolic velocity (PSV), PSV ratio, and peak -to-peak pulsatility index (PPI) were analyzed. This analysis revealed 7 occlusions, 9 stenoses, and 1 arteriovenous fistula. When a PSV < 4 5 cm/s and/or a PSV ratio >2.0 was defined as graft failure, the sensi tivity was 84.0% and the specificity was 81.8%; however, a PPI < 7.0 a t the midgraft, indicating graft failure, showed a sensitivity of 100% and a specificity of 83.3%. The PPI exhibited better sensitivity and specificity than the PSV, even though the PPI needs only to be measure d at the midgraft whereas the PSV should be measured at at least two p oints. Thus, we believe that the PPI could be the most useful and simp le parameter to assess infrainguinal bypass grafts.