COST-SAVING POSTOPERATIVE MONITORING OF I NFRAINGUINAL VEIN GRAFTS

To assess the indications for routine colour flow duplex surveillance, 43 infrainguinal autogenous vein grafts were prospectively entered in to a surveillance protocol. Screening consisted of measurements of ank le brachial indices (ABI) and colour flow duplex imaging of the entire graft length. All grafts at risk had a serial fall in resting ABI of more than 0.1. This study suggests that resting ABI measurements are a very sensitive and non-expensive primary screening procedure, provide d that all grafts with ABI changes of more than 0.1 are further evalua ted. About 60% of ABI-screened grafts needed further evaluation becaus e of ABI changes of greater than 0.1, incompressibility of arteries or extension of the graft to the ankle or pedal arteries. Colour flow du plex scanning was very useful in excluding of identifying and localisi ng graft problems and deciding on further invasive diagnostic and ther apeutic procedures.