Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency?

Enrico Ascer, Frank J. Veith, Martin L. Lesser, Russell H. Samson, Larry A. Scher, Sheila White-Flores, Terry L. Stein, Sushil K. Gupta

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

While it is generally thought that collateral back pressure (CBP) is a reliable predictor of graft patency, this correlation has not yet been validated. We have used a new, simple technique to measure CBP without direct puncture of the recipient artery. After the distal anastomosis is completed, the graft is filled with saline and clamped proximally. A transducer connected needle is then inserted into the distal portion of the graft for CBP measurements (mm Hg). These were obtained in 84 grafts (43 femoropopliteals [FP] and 41 femorodistals [FD]). Outflow resistance (OR) measurements (mm Hg/ml/min) were also obtained in 70 (36 FP; 34 FD) of these grafts by a previously described technique. The mean CBP for FP and FD bypasses was 41 ± 17 and 26 ± 19 mm Hg, respectively (P < 0.001). Although early graft patency (3 months) (13 occluded, 71 patent) did not correlate with angiographic findings of popliteal runoff or integrity of pedal arch, it did significantly relate to CBP. Mean CBP for occluded grafts was 22 ± 17 mm Hg and for patent grafts it was 36 ± 19 mm Hg (P < 0.01). Similarly, mean OR was significantly related to patency, 1.29 ± 0.23 mm Hg/ml/min for occluded grafts and 0.36 ± 0.23 mm Hg/ml/min for patent grafts (P < 0.0001). Moreover, only OR was a significant predictor of infrapopliteal graft patency (P < 0.01). OR was found to be a better predictor of graft patency than CBP by stepwise logistic regression analysis (P < 0.0001). We conclude that CBP is a more reliable predictor of graft outcome than angiographic criteria. However, OR measurement remains the superior predictor for infrainguinal arterial bypass patency and the only reliable predictor of infrapopliteal bypass patency.

Original languageEnglish (US)
Pages (from-to)453-460
Number of pages8
JournalJournal of Surgical Research
Volume38
Issue number5
DOIs
StatePublished - 1985

Fingerprint

Transplants
Pressure
Transducers
Punctures
Needles
Foot
Arteries
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Ascer, E., Veith, F. J., Lesser, M. L., Samson, R. H., Scher, L. A., White-Flores, S., ... Gupta, S. K. (1985). Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency? Journal of Surgical Research, 38(5), 453-460. https://doi.org/10.1016/0022-4804(85)90061-7

Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency? / Ascer, Enrico; Veith, Frank J.; Lesser, Martin L.; Samson, Russell H.; Scher, Larry A.; White-Flores, Sheila; Stein, Terry L.; Gupta, Sushil K.

In: Journal of Surgical Research, Vol. 38, No. 5, 1985, p. 453-460.

Research output: Contribution to journalArticle

Ascer, E, Veith, FJ, Lesser, ML, Samson, RH, Scher, LA, White-Flores, S, Stein, TL & Gupta, SK 1985, 'Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency?', Journal of Surgical Research, vol. 38, no. 5, pp. 453-460. https://doi.org/10.1016/0022-4804(85)90061-7
Ascer, Enrico ; Veith, Frank J. ; Lesser, Martin L. ; Samson, Russell H. ; Scher, Larry A. ; White-Flores, Sheila ; Stein, Terry L. ; Gupta, Sushil K. / Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency?. In: Journal of Surgical Research. 1985 ; Vol. 38, No. 5. pp. 453-460.
@article{f78dee1fbaec46b1a342ac19248edca4,
title = "Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency?",
abstract = "While it is generally thought that collateral back pressure (CBP) is a reliable predictor of graft patency, this correlation has not yet been validated. We have used a new, simple technique to measure CBP without direct puncture of the recipient artery. After the distal anastomosis is completed, the graft is filled with saline and clamped proximally. A transducer connected needle is then inserted into the distal portion of the graft for CBP measurements (mm Hg). These were obtained in 84 grafts (43 femoropopliteals [FP] and 41 femorodistals [FD]). Outflow resistance (OR) measurements (mm Hg/ml/min) were also obtained in 70 (36 FP; 34 FD) of these grafts by a previously described technique. The mean CBP for FP and FD bypasses was 41 ± 17 and 26 ± 19 mm Hg, respectively (P < 0.001). Although early graft patency (3 months) (13 occluded, 71 patent) did not correlate with angiographic findings of popliteal runoff or integrity of pedal arch, it did significantly relate to CBP. Mean CBP for occluded grafts was 22 ± 17 mm Hg and for patent grafts it was 36 ± 19 mm Hg (P < 0.01). Similarly, mean OR was significantly related to patency, 1.29 ± 0.23 mm Hg/ml/min for occluded grafts and 0.36 ± 0.23 mm Hg/ml/min for patent grafts (P < 0.0001). Moreover, only OR was a significant predictor of infrapopliteal graft patency (P < 0.01). OR was found to be a better predictor of graft patency than CBP by stepwise logistic regression analysis (P < 0.0001). We conclude that CBP is a more reliable predictor of graft outcome than angiographic criteria. However, OR measurement remains the superior predictor for infrainguinal arterial bypass patency and the only reliable predictor of infrapopliteal bypass patency.",
author = "Enrico Ascer and Veith, {Frank J.} and Lesser, {Martin L.} and Samson, {Russell H.} and Scher, {Larry A.} and Sheila White-Flores and Stein, {Terry L.} and Gupta, {Sushil K.}",
year = "1985",
doi = "10.1016/0022-4804(85)90061-7",
language = "English (US)",
volume = "38",
pages = "453--460",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "5",

}

TY - JOUR

T1 - Collateral back pressure-Is it a valid predictor of infrainguinal bypass graft patency?

AU - Ascer, Enrico

AU - Veith, Frank J.

AU - Lesser, Martin L.

AU - Samson, Russell H.

AU - Scher, Larry A.

AU - White-Flores, Sheila

AU - Stein, Terry L.

AU - Gupta, Sushil K.

PY - 1985

Y1 - 1985

N2 - While it is generally thought that collateral back pressure (CBP) is a reliable predictor of graft patency, this correlation has not yet been validated. We have used a new, simple technique to measure CBP without direct puncture of the recipient artery. After the distal anastomosis is completed, the graft is filled with saline and clamped proximally. A transducer connected needle is then inserted into the distal portion of the graft for CBP measurements (mm Hg). These were obtained in 84 grafts (43 femoropopliteals [FP] and 41 femorodistals [FD]). Outflow resistance (OR) measurements (mm Hg/ml/min) were also obtained in 70 (36 FP; 34 FD) of these grafts by a previously described technique. The mean CBP for FP and FD bypasses was 41 ± 17 and 26 ± 19 mm Hg, respectively (P < 0.001). Although early graft patency (3 months) (13 occluded, 71 patent) did not correlate with angiographic findings of popliteal runoff or integrity of pedal arch, it did significantly relate to CBP. Mean CBP for occluded grafts was 22 ± 17 mm Hg and for patent grafts it was 36 ± 19 mm Hg (P < 0.01). Similarly, mean OR was significantly related to patency, 1.29 ± 0.23 mm Hg/ml/min for occluded grafts and 0.36 ± 0.23 mm Hg/ml/min for patent grafts (P < 0.0001). Moreover, only OR was a significant predictor of infrapopliteal graft patency (P < 0.01). OR was found to be a better predictor of graft patency than CBP by stepwise logistic regression analysis (P < 0.0001). We conclude that CBP is a more reliable predictor of graft outcome than angiographic criteria. However, OR measurement remains the superior predictor for infrainguinal arterial bypass patency and the only reliable predictor of infrapopliteal bypass patency.

AB - While it is generally thought that collateral back pressure (CBP) is a reliable predictor of graft patency, this correlation has not yet been validated. We have used a new, simple technique to measure CBP without direct puncture of the recipient artery. After the distal anastomosis is completed, the graft is filled with saline and clamped proximally. A transducer connected needle is then inserted into the distal portion of the graft for CBP measurements (mm Hg). These were obtained in 84 grafts (43 femoropopliteals [FP] and 41 femorodistals [FD]). Outflow resistance (OR) measurements (mm Hg/ml/min) were also obtained in 70 (36 FP; 34 FD) of these grafts by a previously described technique. The mean CBP for FP and FD bypasses was 41 ± 17 and 26 ± 19 mm Hg, respectively (P < 0.001). Although early graft patency (3 months) (13 occluded, 71 patent) did not correlate with angiographic findings of popliteal runoff or integrity of pedal arch, it did significantly relate to CBP. Mean CBP for occluded grafts was 22 ± 17 mm Hg and for patent grafts it was 36 ± 19 mm Hg (P < 0.01). Similarly, mean OR was significantly related to patency, 1.29 ± 0.23 mm Hg/ml/min for occluded grafts and 0.36 ± 0.23 mm Hg/ml/min for patent grafts (P < 0.0001). Moreover, only OR was a significant predictor of infrapopliteal graft patency (P < 0.01). OR was found to be a better predictor of graft patency than CBP by stepwise logistic regression analysis (P < 0.0001). We conclude that CBP is a more reliable predictor of graft outcome than angiographic criteria. However, OR measurement remains the superior predictor for infrainguinal arterial bypass patency and the only reliable predictor of infrapopliteal bypass patency.

UR - http://www.scopus.com/inward/record.url?scp=0022392315&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022392315&partnerID=8YFLogxK

U2 - 10.1016/0022-4804(85)90061-7

DO - 10.1016/0022-4804(85)90061-7

M3 - Article

C2 - 3990273

AN - SCOPUS:0022392315

VL - 38

SP - 453

EP - 460

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 5

ER -