Asymptomatic strictures in femoro-popliteal vein grafts

ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary A Collaborative Report From the American Association for Vascular Surgery/Society for Vascular Surgery,⁎⁎AAVS/SVS when Guideline initiated, now merged into SVSSociety for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guideline

“…Prompt evaluation with invasive techniques (angiography) is then indicated when noninvasive methods suggest hemodynamically significant lesions (e.g., greater than 50% stenosis) (25,26). Some patients with failing lower extremity grafts due to stenosis documented by duplex ultrasound may proceed to have operative repair without angiography.…”

“…†Mortality and complication rates are based on n equals 4800, patency rates are based on n equals 1003. ‡Based on a random-effects meta-analysis of the results from various sources, each weighted with the inverse of the variance(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). §Based on a random-effects meta-regression analysis of the results from various sources, each weighted with the inverse of the variance(28 -46).…”

The causes of synthetic vascular graft failure

“…Changes in the wall other than kinking can also cause problems; for instance, the development of stenoses in vein grafts. These occur in approximately 20% of such grafts in the first year after placement and, although they may occur at the site of old valves, they are also common close to graft origins and may be a consequence of handling of the graft during preparation 12 . A policy of duplex vein graft surveillance is essential to detect and treat these stenoses before they cause the graft to fail 13 …”

Five-Years' Experience with Revision of Failing Peripheral Vein Bypasses

“…5,7,8 Postoperative bypass surveillance using noninvasive modalities enables identification of grafts at risk of thrombosis and has become common practice. [9][10][11][12] The optimal treatment of failing grafts, however, remains controversial.13 Some authors are in favor of percutaneous transluminal angioplasty (PTA) as the first-choice therapy,11,1415 whereas others prefer operative repair.…”