Identification of factors predictive of lower extremity vein graft thrombosis

Abstract

Duplex scan velocity measurements are valid predictors of impending graft thrombosis. A Vr of 3.5 or more and an MGV less than 50 cm/s are the best predictive measures. Repair of correctable graft lesions with a Vr of 3.5 or more, or inflow, outflow, or graft lesions associated with an MGV less than 50 cm/s are recommended. Grafts without detectable inflow, outflow, or graft stenoses, regardless of MGV, may be safely followed.

Factors associated with early failure of infrainguinal lower extremity arterial bypass

“…[9][10][11][12][13][14][15] In this study, we were able to identify from a large database the following factors to be associated with a higher risk of early graft thrombosis: patients aged Ͻ60 years, African American patients, nondiabetic patients, and patients with lower hematocrit levels. In addition, although no difference in the risk of early graft failure was found between femoral-popliteal bypass with vein or prosthetic grafts, all types of tibial vessel bypass procedures were associated with a higher chance of early graft failure compared with femoral-popliteal artery bypass with vein, with the exception of a popliteal-tibial vessel bypass with autogenous vein.…”

Trends and outcomes after surgical lower limb revascularization in England

“…Co‐morbidities were also similar, although the incidence of DM was 10 per cent lower than reported in the BASIL trial, and significantly lower than in PREVENT III in which nearly two‐thirds (64 per cent) had DM. This is likely to be due to a combination of underreporting of DM in the HES and international variations in incidence13.…”

Midterm outcome after the distal revascularization and interval ligation (DRIL) procedure

“…Additional imaging and/or treatment was performed for recurrent hand symptoms, significant decreases in the arterial pressures (ie, 15 mm Hg decrease in wrist pressure), and/or abnormal graft scans (ie, mean graft velocity Ͻ50 cm/s, maximum velocity ratio Ն3.5). 18 Data analysis. Patient comorbidities were defined as any prior history of hypertension (any antihypertensive), coronary artery disease (angina, coronary artery bypass, percutaneous coronary angioplasty), peripheral vascular occlusive disease (claudication, ankle-brachial index Ͻ0.9, prior lower extremity revascularization), chronic obstructive pulmonary disease (smoking history Ͼ20 packs/year, abnormal pulmonary function tests, medication), diabetes mellitus (oral hypoglycemics, insulin), congestive heart failure (New York Heart Association Class II or greater), and cerebrovascular occlusive disease (transient ischemic attack, stroke, carotid endarterectomy/angioplasty), graft patency was objectively determined by ultrasound scan or arteriography scan.…”