Post-operative surveillance after open peripheral arterial surgery.

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

PubMedID: 21511502

Lane TR, Metcalfe MJ, Narayanan S, Davies AH. Post-operative surveillance after open peripheral arterial surgery. Eur J Vasc Endovasc Surg. 2011;42(1):59-77.
BACKGROUND
Guidelines and protocols assist in the clinical management of patients, helping to utilise available resources efficiently, however, there is limited documented guidance on surveillance of patients following open arterial surgery. The frequency of clinical follow up, Doppler ultrasound measurements and radiological imaging should all be justified. Here we review the available literature to offer an evidenced based approach to postoperative care.

METHOD
An electronic search was made of Medline and Embase databases through September 2009 revealing over 2300 studies in the initial searches. Following title and abstract screening, the relevant medical literature concerning post-operative surveillance of open vascular procedures was reviewed (300 papers). 42 papers were included in this review. Surveillance recommendations were constructed from the evidence presented.

RESULTS AND CONCLUSION
Detailed anatomical imaging is available for the technical assessment in the majority of patients' postoperative management; however there is little Level 1 evidence to guide modality or timing. Grades B and C recommendations form the majority of surveillance recommendations. Clinical review remains the mainstay of surveillance following open peripheral arterial surgery. Duplex scanning is the imaging modality of choice when indicated in most instances. Minimal data exists to quantify quality of life or intervention efficacy.