The increasing workload required to maintain infrainguinal bypass graft patency

Abstract

To assess the impact upon the provision of a vascular service of the workload associated with maintaining infrainguinal bypass graft patency. A computerised prospective audit. 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. 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. 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.