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Pre-operative hand-held Doppler run-off score can be used to stratify risk prior to infra-inguinal bypass surgery

A H R Stewart1, A Lucas, F C T Smith

  • 1Vascular Studies Unit, Bristol Royal Infirmary, Bristol, UK.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|July 3, 2002
PubMed

Insights

Hand-held Doppler assessment of calf vessel run-off predicts graft patency and patient survival after infra-inguinal bypass surgery. Higher Doppler scores correlate with improved graft success and reduced mortality.

Area of Science:

  • Vascular Surgery
  • Diagnostic Imaging
  • Clinical Outcomes Research

Background:

  • Infra-inguinal bypass grafting is a critical procedure for limb salvage.
  • Assessing distal perfusion preoperatively is essential for predicting surgical success.
  • Hand-held Doppler offers a non-invasive method for evaluating calf vessel run-off.

Purpose of the Study:

  • To determine the relationship between calf vessel run-off, assessed by hand-held Doppler, and outcomes following infra-inguinal bypass surgery.
  • To evaluate the predictive value of Doppler waveform characteristics for graft patency and patient survival.

Main Methods:

  • Prospective cohort study of 258 patients undergoing infra-inguinal bypass grafts.
  • Preoperative assessment of ankle Doppler waveform characteristics (anterior tibial, posterior tibial, dorsalis pedis arteries) to calculate a total Doppler run-off score (0-6).
  • Postoperative graft surveillance using duplex ultrasound and analysis of graft and patient survival via Cox regression.

Main Results:

  • Overall primary assisted graft patency at one year was 80%.
  • A significant positive correlation was observed between increasing Doppler scores (0-6) and primary assisted graft patency (50% to 100%, p = 0.0002).
  • A significant inverse correlation was found between increasing Doppler scores and patient mortality (50% to 5%, p = 0.0003).

Conclusions:

  • Preoperative hand-held Doppler assessment of calf vessel run-off is a valuable tool in infra-inguinal bypass surgery.
  • Higher Doppler scores are associated with improved graft patency and enhanced patient survival.
  • This non-invasive technique can aid in patient selection and risk stratification for infra-inguinal revascularization procedures.
Abstract

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