Color flow duplex screening of infrainguinal grafts combining low- and high-velocity criteria

Target lesion characteristics in failing vein grafts predict the success of endovascular and open revision

“…Duplex diagnostic criteria for lesions requiring interventions were used from previously described parameters. 1,2 Lesions with peak systolic velocity Ͼ300 cm/s, mid-graft velocities Ͻ45 cm/s, and velocity ratios Ͼ3.5 were considered critical in nature, prompting revision. Methods of repair were not randomized and varied according to the discretion of the operating surgeon/ interventionalist.…”

Usefulness of Peak-to-Peak Pulsatility Index in Infrainguinal Bypass Graft Surveillance

“…Color-duplex sonography is widely used for postoperative graft surveillance of femoropopliteal or femorocrural bypasses, and several studies have described criteria for diagnosing severe graft stenosis or hemodynamic failure of a graft. [3][4][5][6][7] A localized increase in PSV in the stenotic area and a low PSV in the entire graft are essential to assess infrainguinal bypass grafts. Taylor et al 5 used two criteria to detect a graft at high risk, namely, a localized increase in the peak velocity (V2) in the area of stenosis by 100% or more in comparison with the peak velocity (V1) 2 cm upstream (that is, a V2/V1 ratio Ͼ2.0, and a decrease in PSV to less than 45 cm/s).…”

“…Pulsed-wave Doppler flow velocity measurements and color-duplex scans have recently been shown to evaluate infrainguinal bypass grafts more accurately. [3][4][5][6][7] By using an effective diagnostic protocol, these new modalities have improved the sensitivity and specificity for diagnosing graft-threatening stenosis. Although previous criteria were useful to diagnose a significant stenosis, it was mandatory to scan an entire graft to detect any localized increase in peak systolic velocity (PSV).…”

Postoperative Infrainguinal Bypass Graft Surveillance: State of the Art

“…It has been observed, however, that this criterion had a low sensitivity for focal lesions and that low PSVgraft values were frequently caused by runoff or inflow disease. [47][48][49] In contrast the specificity of the PSV-graft was found to be high. If low-velocity criteria are used, this is usually in combination with high-velocity criteria in order to enhance the diagnostic accuracy of the tests.…”