The long-term outcome of infrainguinal vein graft surveillance.

Abstract

Vein graft surveillance is of proven benefit in improving graft patency at least in the first year after arterial bypass surgery. The aim of this study was to look at the longer term outcome of a vein graft surveillance programme on graft patency. One hundred and twelve consecutive vein grafts in 106 patients were prospectively entered into a vein graft surveillance programme. The median (range) follow up was 34 (1-76) months. There were 23 (21%) early (less than 1 month) failures and a further 15 grafts occluded during follow up. The primary, primary assisted and secondary patencies at 4 years were 27%, 59% and 67% respectively. Thirty-eight grafts (34%) developed at least one stenosis at a median interval of 5 months after the operation. Eight (21%) of these stenoses occurred more than 12 months after surgery and would have been missed had surveillance been curtailed after 1 year. The benefits of graft surveillance extend beyond one year and surveillance should therefore continue indefinitely.