At what peak velocity ratio value should duplex-detected infrainguinal vein graft stenoses be revised?

Abstract

To determine the peak velocity ratio (PVR) threshold at which to intervene and correct duplex detected vein graft stenoses. Prospective study. Infrainguinal vein grafts in patients attending the vascular studies for routine postoperative surveillance. Colour duplex detected stenotic vein graft lesions with a peak velocity ratio (PVR) between 2.0 and 2.9 were identified and monitored by serial duplex scans performed monthly for 3 months and then at 3-monthly intervals thereafter. At the end of the study period, the outcome of these lesions were analysed. Thirty-eight lesions were identified from 32 grafts. Of these lesions, sixteen (42%) resolved, 11 (29%) remained stable and 11 (29%) progressed to a PVR of > or = 3.0 and underwent angioplasty. There were no occlusions in any of the grafts during the period of study. Colour duplex detected vein graft stenoses with a PVR of less than 3.0 can be treated expectantly if grafts with stenoses with a PVR 2.0-2.9 are scanned every month for at least 3 months after detection.