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Rationale and Benefits of Surveillance After Prosthetic Infrainguinal Bypass Grafts

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Noninvasive Peripheral Arterial Diagnosis

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Abstract

Infrainguinal revascularization with autogenous conduit remains the gold standard of care for the treatment of critical lower extremity ischemia when bypass is required. One of the major factors diminishing long-term patency of these grafts is the development of stenosis of the graft or inflow and outflow arteries.Twenty to forty percent of all infrainguinal bypass grafts will develop stenosis due to different factors.1 It is critical to identify these lesions while grafts are patent, as treatment with minor procedures will maintain patency, while treatment after thrombosis is significantly more morbid and less successful. Clinical examination looking for signs and symptoms of limb ischemia, including pulse evaluation and with measurement of ankle systolic pressure, can usually identify only the very high grade stenoses or occlusions. Over the past two decades there has been increasing evidence to support postoperative surveillance of arterial bypass grafts to improve long-term patency. The use of duplex ultrasound (DU) surveillance for infrainguinal vein grafts has become widely accepted.2 We have suggested that DU is also applicable for prosthetic bypass grafts.3

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Author information

Authors and Affiliations

  1. Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA, USA

    Stephen Kolakowski Jr, Keith D. Calligaro MD (Chief), Sandy McAffe-Benett RVT, Kevin J. Doerr RVT, Kathy Mueller RVT & Matthew J. Dougherty MD

Authors
  1. Stephen Kolakowski Jr
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  2. Keith D. Calligaro MD
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  3. Sandy McAffe-Benett RVT
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  4. Kevin J. Doerr RVT
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  5. Kathy Mueller RVT
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  6. Matthew J. Dougherty MD
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Editor information

Editors and Affiliations

  1. Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, WV, USA

    Ali F. AbuRahma MD, FACS, FRCS, RVT, RPVI (Professor, Chief, Vascular/Endovascular Surgery, Medical Director, Vascular Laboratory, Co-Director, Vascular Center of Excellence) (Professor, Chief, Vascular/Endovascular Surgery, Medical Director, Vascular Laboratory, Co-Director, Vascular Center of Excellence)

  2. Charleston Area Medical Center, Charleston, WV, USA

    Ali F. AbuRahma MD, FACS, FRCS, RVT, RPVI (Professor, Chief, Vascular/Endovascular Surgery, Medical Director, Vascular Laboratory, Co-Director, Vascular Center of Excellence) (Professor, Chief, Vascular/Endovascular Surgery, Medical Director, Vascular Laboratory, Co-Director, Vascular Center of Excellence)

  3. UCSD School of Medicine, La Jolla, CA, USA

    John J. Bergan MD, FACS, Hon FRCS

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Kolakowski, S., Calligaro, K.D., McAffe-Benett, S., Doerr, K.J., Mueller, K., Dougherty, M.J. (2010). Rationale and Benefits of Surveillance After Prosthetic Infrainguinal Bypass Grafts. In: AbuRahma, A.F., Bergan, J.J. (eds) Noninvasive Peripheral Arterial Diagnosis. Springer, London. https://doi.org/10.1007/978-1-84882-955-8_7

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  • DOI: https://doi.org/10.1007/978-1-84882-955-8_7

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-954-1

  • Online ISBN: 978-1-84882-955-8

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