Preoperative prediction of graft patency for infrapopliteal arterial bypass using pulse-generated runoff

Objective: to assess: (i) pulse-generated runoff (PGR) as a tool for preope rative prediction of graft patency; (ii) the effect of PGR use on graft pat ency. Design: retrospective analysis of continuous patient data. Materials: all patients undergoing bypass to the infrapopliteal vessels in the Oxford Regional Vascular Unit between 1989 and 1993. Methods: preoperative assessment using ankle-brachial indices, intra-arteri al digital subtraction angiography and PGA. Six-monthly and then yearly cli nical and duplex sonography follow-up to assess graft patency. Univariate a nalysis of graft patency to assess discriminatory ability of PGR for graft patency. Results: a biphasic signal in the artery of insertion was associated with s ignificantly better graft patency rate at 1 month and at maximum follow-up than was a monophasic signal. A monophasic signal was associated with a 12- month patency of 25% and a mortality of 37.7%. Use of PGR did not affect graft patency significantly. Conclusion: PGR is a useful, non-invasive, means of preoperative patient as sessment to determine the potential for maintained graft patency.