THE AD HOC ESTIMATION OF OUTFLOW DOES NOT PREDICT PATENCY OF INFRAINGUINAL RECONSTRUCTIONS

Objectives: This prospective study was performed to evaluate the clini cal implication of the AdHoc estimation (also called SVS score) of out flow on patency of infrainguinal in situ femoropopliteal or -distal by passes. Methods: The bypasses were followed with Duplex scanning at 1, 3, 6, and 12 months after surgery. Fifty-three bypasses were recruite d for the study, 20 of which were performed in 17 diabetics. In 47% th e AdHoc scoring was less than or equal to 4.5 and in 53% it was betwee n 5 and 10 (1 corresponds to an excellent outflow and 10 to a blind se gment). Results: Within the first 30 days eight occlusions occurred al l of which were surgically corrected. The AdHoc score for these bypass es was 4.2 vs. 4.9 (Ns) for those who did not occlude. During follow-u p, revisions were performed in 21 cases (40%) with 30 interventions. A t the end of 1 year, 68% of the bypasses were patent (80% among diabet ics and 64% among non-diabetics, Ns). Patency at 1 year was not influe nced by the AdHoc classification. Conclusion: The estimation of outflo w from angiography seems to be of no value in predicting graft patency in infrainguinal grafting.