Diagnosis and management of failing infrainguinal grafts

ABSTRACT

A surveillance program was done in the period between January, 1984 to December 1995 on 74 patients [79 limbs] in which infrainguinal graft bypass was performed in Al-Azhar University and Therapeutic Establishment Hospitals. Patients were followed up for a period from 6 to 36 months; by clinical, doppler flowmetry, systolic ankle brachial pressure indices, duplex scan, and conventional or digital subtraction angiography. In 23 limbs [19 patients], a patent but hemodynamically failing grafts were identified. Different methods of correction of the failing graft were used according to the cause of hemodynamic defect. The primary patency was 71.1%, the associated primary patency was 85% and the secondary patency was 94%. This study stressed on the importance of the surveillance program for early detection and management of the failing graft before complete occlusion and limb threatening ischemia