563 Graft Failure After Revascularization of CLTI Patients: Graft Surveillance

Background Failure of infrainguinal bypass grafts remains, despite expert surgeons and meticulous surgical technique, a matter of concern for both patient and surgeon. Anastomotic intimal hyperplasia is commonly greater at the downstream or at the outflow anastomosis. All infrainguinal bypasses should go under routine surveillance to pick the grafts at risk for the prevention of graft failure. Aim The aim was to find out if we are following the standard guidelines in the management of CLTI patients, including postoperative follow up. Also, to monitor whether the patients were having postoperative Duplex surveillance scan to pick any graft at risk. Method All patients were included who underwent infra-inguinal bypass procedure for CLTI during last 8months (from mid-January to Mid-September 2023) in our Vascular unit. Retrospective data were collected. Results Total 38 patients had lower limb bypass procedure over last 8 months (from 15th January till 14th September 2023). However, two Fem- Fem crossover, one Ilio-popliteal and one Pedal bypass were excluded. Thus, total 36 patients were included for the study (n=34). The vast majority (n=27, 79.4%) had Femoro Popliteal Bypass (AK/BK) and the rest (n=7, 20.5%) had Distal bypass (Fem-distal or Pop-distal bypass). 18% patients had amputation and 15% patients died. 61% of the remaining patients were on surveillance. Those, who were not on surveillance, 44% of them had graft occlusion. Conclusions Surveillance can predict graft at risk and the graft occlusion can be prevented by appropriate intervention. Every vascular unit should have their own post procedural follow up strategies.