Incidence of stenoses in femorodistal bypass vein grafts in a multicentre study

Objectives: to establish the incidence of graft stenosis in a large population of patients undergoing femorodistal bypass procedures and to investigate the difference in incidence between individual surgical centres and other subpopulations. Patients and methods: a total of 277 patients with femorodistal bypasses underwent duplex scanning of vein grafts for 12 months for the detection of graft stenoses. A standard definition of a significant stenosis was used in all twenty participating centres. Results: overall stenosis rate was 27%. Stenosis were more common in composite vein grafts (43%) than in single segment vein grafts (25%) p=0.05. Stenoses were more common in female patients (38%) than males (22%) p=0.02. Stenosis rates in individual centres entering more than 20 patients varied from 9% to 56%. In a multiple regression analysis only aspirin use, sex and centre were significant factors predicting the likelihood of graft stenosis. Conclusion: female patients, those taking aspirin and patients with composite vein grafts appear to be more at risk of graft stenosis, but this does not fully explain wide variations in the incidence of stenoses reported by individual centres.