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Ankle Systolic Pressure Index and Early Vein Graft Failure-Reply

Arch Surg. 1979;114(9):1091. doi:10.1001/archsurg.1979.01370330113024.
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In Reply.—Clearly there is a difference between Dr Dean's results and our results with regard to the incidence of early failure of femoropopliteal vein grafts when the preoperative ankle systolic pressure index (ASPI) is low. He found this failure rate to be prohibitive,1 and we found it to be acceptable.2 In his letter, Dr Dean suggests that this difference may be the result of the inclusion of femorotibial grafts along with femoropopliteal grafts in our study. As a result of his query, we have again reviewed our results in patients undergoing vein graft reconstruction where the preoperative ASPI was low (<0.2). Of this group of 17 patients, we were surprised to find only one who had a femorotibial graft. The early failure rate in the remaining 16 patients who underwent femoropopliteal vein grafts was 31% (5/16). The other 19 grafts to vessels distal to the popliteal artery


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