Prediction of the immediate outcome of femoropopliteal saphenous vein bypass by angiographic runoff score.

Abstract

To determine the value of the Ad Hoc scoring system (SVS/ISCVS) in predicting the immediate outcome of femoropopliteal saphenous vein grafts. Retrospective study. One hundred and twenty patients underwent 132 primary femoropopliteal vein bypass procedures, 32 for claudication and 100 for critical leg ischemia (CLI). The outflow arteries were graded according to the Ad Hoc scoring system (SVS/ISCVS). Postoperative immediate graft patency and leg salvage to the period of the first 30 days after surgery. Ninety-one per cent of claudicants and 83% of CLI patients had immediate patency. The overall 30-day patency rate was 85%. Leg salvage rate was 91% for the patients with CLI. Patients with score in the highest quartile were found to have a 8.7 times higher risk for immediate graft occlusion (p = 0.005). Multivariate analysis showed that the Ad Hoc score was predictive of immediate patency (p = 0.0006) and leg salvage (p = 0.0004). In patients with a score < or = 7.5 and in those with a score > 7.5, the patency rates were 95% and 66% (p = 0.001), and the leg salvage rates were 97% and 80%, (p = 0.004), respectively. The Ad Hoc scoring system is useful in predicting the immediate outcome of femoropopliteal saphenous vein grafts.