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The increasing workload required to maintain infrainguinal bypass graft patency
I M Loftus1, A Reid, M M Thompson
1Department of Surgery, Leicester Royal Infirmary, U.K.
Insights
Maintaining infrainguinal bypass grafts requires significant interventions, impacting vascular service workload. This workload increased substantially over a six-year period, necessitating careful planning for vascular service provision.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Health Services Management
Background:
- Assessing the workload of maintaining infrainguinal bypass graft patency.
- Understanding the impact on vascular service provision.
Purpose of the Study:
- To quantify the interventions required for infrainguinal bypass graft patency maintenance.
- To evaluate the impact of this workload on vascular services.
Main Methods:
- Prospective computerized audit of patients with infrainguinal bypass grafts (1990-1995).
- Monitoring interventions for graft patency, excluding early postoperative procedures.
- Graft surveillance program in operation throughout the study period.
Main Results:
- 131 patients with 144 grafts underwent 401 interventional procedures over six years.
- Radiological interventions constituted nearly 70% of the total workload.
- Significant interventions were noted across femorodistal, below-knee, and above-knee femoropopliteal grafts.
Conclusions:
- The workload for infrainguinal bypass graft maintenance has significantly increased.
- This trend is projected to continue, requiring consideration in vascular service planning.
- Interventional procedures are a major component of graft maintenance workload.
Background:
To assess the impact upon the provision of a vascular service of the workload associated with maintaining infrainguinal bypass graft patency.
Design:
A computerised prospective audit.
Materials And Methods:
Between January 1990 and December 1995, all patients with infrainguinal bypass grafts were entered into a prospective computerised audit to monitor interventions for the maintenance of graft patency. Excluded from the study were interventions during the first 30 postoperative days and procedures not directly related to the graft. A graft surveillance programme was in operation throughout.
Results:
During the study period a total of 131 patients with 144 grafts were admitted on 330 occasions and required 401 separate interventional procedures. There were 227 procedures in 72 femorodistal grafts, 116 in 38 below-knee femoropopliteal grafts and 58 interventions in the group of 34 above-knee femoropopliteal grafts. Radiological interventions accounted for almost 70% of this workload.
Conclusion:
The workload associated with the maintenance of infrainguinal bypass grafts increased considerably during the study period, and seems likely to increase further. Such interventions should therefore be considered when planning for vascular service provision.