Infrainguinal vein graft surveillance: the criteria for intervention

In most patients, infrainguinal vein grafts are commonly performed for limb-threatening ischemia. Once limb salvage has been achieved, most clinicians agree that regular appointments with the vascular team are important to monitor graft patency. However, the timing of these appointments and what defines an adequate examination remains debatable. The following cases illustrate the natural history and interventions performed in 2 such patients. A review of the literature and a commentary on surveillance strategies is provided to elucidate the advantages and disadvantages of currently available vascular laboratory testing. Recommendations also are made for the appropriate timing of intervention to revise these grafts.