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

Abstract

One point measurement of the PPI in the mid-graft could be a simple and useful parameter for diagnosing graft failure, based on our finding that the waveform was very similar in the proximal artery, the entire graft, and the distal artery. PPI was inversely correlated with average mode frequency because reverse flow decreased or diminished when a significant stenosis existed.

Impact of In Vivo Ranges of the Variances in the Flow Velocity Waveforms and Flow Split Ratio on the Hemodynamic Effects of the Anastomotic Cuff at Distal End-to-Side Anastomosis

“…However, if functional stenosis was not detected between the inlet and outlets of the anastomosis, then the inlet flow velocity profiles would not be affected by the geometries of the anastomoses. 7,8 Furthermore, the global structures of the flow field have been demonstrated to be largely unchanged by such simplifications, and similar results would thus be obtained by the distribution and magnitude of the timeaveraged wall shear stress after the inclusion of wall distensibility in this model. 12 In conclusion, hemodynamics inside the distal anastomosis are affected not only by the geometry of the anastomosis but also by the inlet flow velocity profiles and the outflow blood distribution ratio.…”

“…However, the flow variables investigated in the present study did not seem to be precisely predicted by any preoperative examinations. 7 There may be another design of the cuff for distal anastomosis that can handle such a wide range of variations in these flow variables. The flow conditions in distal anastomosis are evidently affected by various factors, including heart rate, effect of exercise, route of conduits, and deformation of the conduits and anastomoses caused by hip and knee joint movements.…”

“…Furthermore, only a few studies have considered differences in the flow velocity waveforms. 7,8 Neither the in vivo ranges of these variables at the distal anastomoses of femoropopliteal bypasses (FPBs) nor their impacts on the hemodynamic effects of the cuff have been evaluated previously.…”