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Objective: Duplex ultrasound surveillance (DUS) is commonly used following infrainguinal vein bypass. The role of DUS following endovascular revascularisation is as yet unclear. This study focuses on the role of DUS in a contemporary group of patients undergoing infrainguinal bypass or stent insertion. Methods: All patients undergoing either an infrainguinal vein graft bypass or stent insertion into the femoro-popliteal segment (November 2014 - January 2017) were identified. Patients were followed up for 2 years. Data on entry into DUS, pre-operative characteristics, adjunctive pharmacotherapy and reintervention were collated. The primary outcomes were major lower limb amputation and mortality at 2 years post revascularisation. Results: One hundred and thirty-five patients underwent infrainguinal vein bypass and 100 patients underwent stent insertion. 107 patients in the bypass cohort and 58 patients in the stent cohort entered DUS. For the bypass cohort, entering DUS was associated with a lower mortality rate (P =.003) but was not associated with an improvement in amputation rates. The odds ratio of major amputation or mortality was greater in the no surveillance group (4.58, 95% CI: 1.855 – 11.364). In the stent cohort, DUS was not associated with a significant improvement in either major amputation or death (odds ratio 2.13 (95% CI 0.903 – 5.051; P =.081). Conclusion: DUS was associated with improved survival rates in patients undergoing lower limb bypass but had no benefit in those patients undergoing stent insertion. The role of DUS following stent insertion in the femoropopliteal segment needs to be better defined. [ABSTRACT FROM AUTHOR]

Background: Little is known about the ideal residual length of the great saphenous vein (GSV) stump and its potential role in complications such as acute deep venous thrombosis (DVT) and recanalization. This study was designed to learn about the natural history of the residual GSV stump length following endovenous laser treatment. Methods: Prospective data were collected from 50 limbs of 50 patients over an 11-month period. Clinical assessment and duplex ultrasound were performed preoperatively, at 24 hours and at 3 months after the procedure. Results: The residual GSV stump decreased in length from a mean of 15 mm at 24 hours to 13 mm at 3 months after the procedure. None of the patients developed acute DVT or proximal recanalization when the laser tip was positioned 28 mm distal to the saphenofemoral junction. Conclusion: Endovenous laser therapy of the GSV for symptomatic reflux is safe and effective. The residual GSV stump decreased in length over a 3-month period. [ABSTRACT FROM AUTHOR]

Background: Chronic occlusive mesenteric ischaemia can be treated surgically or endovascularly. Endovascular techniques as elsewhere in the vascular tree are limited by restenosis. The aim of this study was to determine if duplex ultrasound proven restenosis correlates with recurrence of symptoms. Methods: Our study looks at successful percutaneous revascularization of the mesenteric circulation associated proven restenosis using colour Doppler ultrasound and the relation to recrudescence of symptoms or weight loss. A retrospective review of five patients treated endovascularly at our institution for mesenteric angina secondary to visceral artery stenosis was carried out. Results: Technical success was achieved in four out of the five patients in our study. One patient had a procedure complicated by thrombus in the coeliac axis and superior mesenteric artery (SMA) stents, subsequently showed SMA occlusion and 90% stenosis of the CA and inferior mesenteric artery and required an aorto-mesenteric graft. Three of the four patients with a technically successful procedure had significant (>70%) restenosis of the SMA. All three, including one patient with both SMA restenosis and chronic inferior mesenteric artery occlusion, remain asymptomatic and have maintained their postprocedural weight gain. Conclusion: Although ultrasound is a convenient, non-invasive tool for follow up of endovascular treatment of mesenteric stenosis, its use is unclear as in our study restenosis did not correlate with recrudescence of symptoms. [ABSTRACT FROM AUTHOR]