Resolution of Saphenous Vein Graft Stenosis with Exercise: A Case Report

Duplex USS (A) revealed almost complete occlusion of the CFA (short arrow) with proximal thrombus (long arrow) and ischaemic distal flows (inset). The resected specimen (B) revealed the anterior and posterior vessel walls to have been plicated by the suture line (long arrow) causing the severe stenosis.

Duplex USS at six weeks (A) suggested significant stenosis with four-fold increase in PSV across the proximal anastomosis (120–480cm/s) and monophasic flows within the graft (inset). Repeat USS 3 months later (B) demonstrated patent graft without obvious stenosis, PSV increase across the graft was no longer significant (168–278cm/s); flows were multiphasic (inset).

CFA angiogram at seven weeks demonstrated an anastomotic shelf at the proximal graft anastomosis (short arrow) and a “kinked” distal anastomosis (long arrow) but good flow in the superficial femoral artery, profunda femoris and popliteal artery.