[Value of routine follow-up after infrainguinal arterial reconstruction]

Longterm patency of infrainguinal bypass procedures may be established on the basis of clinical evaluation and ankle pressure measurements. With the aim of assessing whether these parameters could predict grafts at risk for occlusion, we identified 24 patients in whom the bypass had occluded between 3 and 12 months postoperatively, but following at least one follow-up. These patients were compared with a control group consisting of further 24 patients operated on during the same period, but in whom the bypass was patent. Prior to graft occlusion only nine (39%) patients had complained of claudication, and a significant drop in ankle pressure was demonstrated in seven (29%) patients. These figures were significantly higher than the one (4%) patient in the control group who complained of claudication and the other (4%) patient who developed a drop in ankle pressure (p < 0.02 and 0.05, respectively). Graft surveillance based on patients' history and ankle pressure measurements are insufficient parameters for identification of grafts at risk for occlusion. However, the occurrence of claudication and/or a significant drop in ankle pressures are associated with a high incidence of graft thrombosis.