Does a completely accomplished duplex-based surveillance prevent vein-graft failure?

Objectives: to assess the benefits of duplex-based vein-graft surveillance over clinical surveillance with distal pressure measurements. Design: prospective randomised comparative trial. Material and methods: three hundred and forty-four patients with 362 consec utive infrainguinal vein bypasses were prospectively randomised to a follow -up regime with or without duplex scanning (ABI group and DD group) at 1, 3 , 6, 9, and 12 months postoperatively. Results: one hundred and eighty-three grafts were enrolled to the ABI group and 179 to the DD group. The primary assisted patency, secondary patency a nd limb salvage rates were 67%, 74%, 85% for the ABI group and 67%, 73%, 81 % for the DD group. Ninety grafts in the ABI group and 57 in the DD group h ad surveillance that completely adhered to the protocol. The outcome was al so similar for these groups at one year (77%, 87%, 94% and 77%, 83%, 93% re spectively), although grafts were revised more frequently in the DD group. Conclusions: intensive surveillance with duplex scanning did not improve th e results of any outcome criteria examined. To demonstrate any potential be nefit of duplex scanning for vein-graft surveillance a multicentre study wi th a large number of patients to ensure sufficient power is needed.