Tidlige erfaringer med duplexovervågning af femoropopliteale og -krurale vene-bypass

Identification and correction of graft stenoses in femoropopliteal and -crural vein bypasses can prevent reconstruction failure. Sixty six consecutive vein bypasses entered a postoperative surveillance protocol, which implied clinical assessment, measurement of ankle blood pressure and duplex-scanning every three months. In 15 cases the duplex-scanning indicated graft stenoses. Seven were revised, five of which remain patent after a median follow-up of three months. Eight stenoses were observed without intervention. Five of these uncorrected stenoses (63%) thrombosed and the function of the bypass could not be reestablished. Of the 34 bypasses with normal duplex-scans only 2 (6%) thrombosed (p < 0.01 compared to observed but not revised stenosis). Neither clinical evaluation or ankle blood pressure measurement could reliably predict graft failure. This study indicates that duplex-scanning effectively identifies grafts at risk and can be expected to improve long-term patency of infrainguinal vein bypasses.