The effect of a surveillance programme on the patency of synthetic infrainguinal bypass grafts

Objectives: Vein graft surveillance is widely acknowledged to be of benefit in improving graft patency at least in the first year after arterial bypass surgery. The aim of this study was to examine the effect of a surveillance programme on the patency of synthetic infrainguinal bypass grafts. Design: A prospective study of 69 consecutive prosthetic bypass grafts was undertaken over a 3 year period. Methods: Patients were seen at 3 monthly intervals after surgery and underwent measurement of ankle brachial pressure indices and a colour Duplex scan of the graft. Results: The surveillance programme was able to detect treatable lesions in five grafts and in the run-off vessels of two other grafts prior to occlusion. However 14 grafts failed after the first 30 days, 12 of which were not predicted by the surveillance programme. Conclusions: Surveillance appears to be of limited benefit in the maintenance of patency of synthetic infrainguinal bypass grafts.