Lower-extremity vascular grafts placed for peripheral vascular disease: prospective evaluation with duplex Doppler sonography.

Abstract

Eighty-five men with 92 vascular grafts placed for peripheral vascular disease of the lower extremity underwent a total of 264 examinations with duplex Doppler over a 2.5-year period. In 64 patients who underwent more than one examination, the total follow-up encompassed 740 months. In 220 native femoral arteries (96.0%) the peak systolic velocity (PSV) was higher than that in the graft. Arteriovenous shunting was associated with a normal PSV and a markedly elevated diastolic component at spectral analysis. Focal fluid collections were common initially near the graft and usually disappeared uneventfully. An average PSV of 32 cm/sec or less was always associated with impending occlusion. The sensitivity of an average PSV of 40 cm/sec or less to indicate impending graft occlusion by the next visit was only 33%; the specificity, 94%. At initial examination, stenoses were associated with high PSV focally in the graft or low PSV with absent diastolic flow.

Results and functional outcomes of en-bloc resection and vascular reconstruction in extremity musculoskeletal tumors

“… 2 , 7 However, there is not enough scientific data concerning the need of a venous repair regarding either the need to do or not to do it. 9 , 10 Moreover limb-sparing surgery has the opportunity to provide good or excellent limb function after the intervention. 11 , 12 …”

“…Arterial reconstruction, which can be performed with synthetic or autologous vein grafts, is almost always inevitable to preserve the limb in most of the cases because the risk of ischemia and limb loss is very high unless an arterial reconstruction is carried out 2, 7. However, there is not enough scientific data concerning the need of a venous repair regarding either the need to do or not to do it 9, 10. Moreover limb-sparing surgery has the opportunity to provide good or excellent limb function after the intervention 11, 12…”