The evaluation of run-off prior to infra-inguinal bypass reconstruction - a modified scoring system based on flow measurement.

OBJECTIVES: To compare angiographic scoring and flow measurements in the assessment of run-off prior infra-inguinal bypass. PATIENTS AND METHODS: In a series of 108 consecutive infra-inguinal bypasses, run-off was scored on the basis of pre- and post-operative angiograms and related to intra- and post-operative flow rates as determined by Doppler ultrasonography. RESULTS: There was a highly significant correlation between the angiographic score and flow (p = 0.0000), as well as between angiographic score (p = 0.0000), flow (p = 0.0000) and the level of distal anastomosis. Flow determined per crural vessel (quotient of flow to angiographic score) proved to be independent of the level of distal bypass anastomosis (p = 0.20). CONCLUSION: In this study, angiographic scoring and Doppler flow measurements were equally valid means for the assessment of run-off. Our system allows an objective assessment of run-off independently of the distal bypass anastomosis level and provides a functional estimation of run-off.