Prediction of the immediate outcome of femoropopliteal saphenous vein bypass by angiographic runoff score

Objectives: To determine the value of the Ad Hoc scoring system (SVS/ISCVS) in predicting the immediate outcome of femoropopliteal saphenous vein grafts. Design: Retrospective study. Materials: One hundred and twenty patients underwent 132 primary femoropopliteal vein bypass procedures, 32 for claudication and 100 for critical leg ischemia (CLI). Methods: The outflow arteries were graded according to the Ad Hoc scoring system (SVS/ISCVS). Postoperative immediate graft patency and leg salvage to the period of the first 30 days after surgery. Results: Ninety-one per cent of claudicants and 83% of CLI patients had immediate patency. The overall 30-day patency rate teas 85%. Leg salvage rare was 91% for the patients with CLI. Patients with score in the highest quartile were found to have a 8.7 times higher risk for immediate graft occlusion (p = 0.005). Multivariate analysis showed that the Ad Hoc score was predictive of immediate patency (p = 0.0006) and leg salvage (p = 0.0004). In patients with a score less than or equal to 7.5 and in those with a score >7.5, the patency rates were 95% and 66% (p = 0.001), and the leg salvage rates were 97% and 80%, (p = 0.004), respectively. Conclusions: The Ad Hoc scoring system is useful in predicting the immediate outcome of femoropopliteal saphenous vein grafts.