Surveillance of above-knee prosthetic femoropopliteal bypass

Objectives: to evaluate a surveillance programme based on colour duplex ultrasound scanning of above-knee prosthetic femoropopliteal bypass. Design: a retrospective clinical study. Materials: one hundred and eighteen above-knee prosthetic femoropopliteal bypass procedures performed from 1993 to 1996. Methods: scans were done at 1, 3, 6 and 12 months, and annually thereafter. significant graft-related stenotic lesions were defined as 50% diameter reduction or more located at the inflow or outflow arteries, or associated with the graft. Identified lesions were treated by angioplasty or surgical repair. Results: the primary and secondary potency rates at 2 years were 55% and 71%, respectively. Stenotic lesions were documented on 45 of 463 scans (9.7%). Twenty-nine grafts (25%) were treated and only six of these grafts (21%) occluded. This was significantly superior to the occlusion rate of 41% for the whole series. Conclusions: it appears that one-quarter of above-knee prosthetic femoropopliteal bypasses develop graft-related stenoses. The favourable prognosis of these grafts after treatment fdr stenotic lesions justifies a surveillance programme. However, most graft occlusions seem to occur in grafts where no stenotic lesion has been previously detected.