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.