The predictive value of intraoperative duplex for early vein graft patencyin lower extremity revascularization

This study was undertaken to evaluate the ability of intraoperative duplex scanning during infrainguinal vein bypass to identify technical abnormaliti es and to determine the relation between intraoperative scan result and ear ly primary graft patency. We retrospectively reviewed of 78 consecutive int raoperative duplex scans for infrainguinal vein bypass that were performed between October 1993 and October 1996 during the course of infrainguinal ve in bypass. Duplex scans were classified as normal or abnormal based on B-mo de image and/or Doppler velocity spectra. Grafts were grouped according to duplex findings and intraoperative action: group I, normal intraoperative s can; group II, abnormal intraoperative scan, revised; group III, abnormal i ntraoperative scan, not revised. The relationship of intraoperative duplex scan findings to intraoperative graft revision to 1-month and 6-month prima ry graft patency by life table was analyzed. The analysis demonstrates that the results of intraoperative duplex scans can be used to identify grafts at low risk for early postoperative graft failure (groups I and II), and th ose at high risk for early postoperative graft failure (group III).