F F Abdallah, Joanne Fuller, G Kuhan, JV Smyth, N Chalmers, F Serracino-Inglott. Can a Fast Track Referral System Improve the Effectiveness of a Graft Surveillance Programme? SLR Vasc Med 2017;2(1): 006-009
Abstract
Purpose: To assess the effectiveness of a fast track referral system from Vascular Laboratory to Interventional Radiology on threatened vein bypass grafts in the lower limbs.
Methods: A Fast Track System (FTS) was set up in February 2011 to minimise the delay from duplex scan to intervention for bypass grafts with identified significant stenoses. 111 scans were performed pre - FTS over one year and compared with 190 scans which were performed post-FTS introduction over two years.
Results: Significant stenoses were identified in 24 scans (22%) before FTS, of which, 6 (25%) had no intervention, 15 (62.5%) had interventions and 3 (12.5%) were occluded by the time of intervention. The median delays from duplex to referral to radiology and from duplex to intervention were 32 and 56 days respectively. After the introduction of FTS, 35 scans were noted to have significant stenoses. Only 23 (66%) of them had interventions. The median delays from duplex scan to referral to radiology and from duplex to intervention were 0 and 20 days respectively. There was one graft (3%) occlusion after the introduction of FTS by the time of the angiogram compared with 3 (12.5%) in the pre-FTS group (p = 0.35).
Conclusions: Approximately 20% of the scans performed over one year for infra-inguinal bypass are at risk of failure. The FTS has reduced the time - delay from Duplex scan to referral to radiology and the number of occluded grafts. Further improvement is needed to reduce the delay between the referral and intervention
https://www.sciresliterature.org/VascularMedicine/VM-ID13.pdf
Abstract
Purpose: To assess the effectiveness of a fast track referral system from Vascular Laboratory to Interventional Radiology on threatened vein bypass grafts in the lower limbs.
Methods: A Fast Track System (FTS) was set up in February 2011 to minimise the delay from duplex scan to intervention for bypass grafts with identified significant stenoses. 111 scans were performed pre - FTS over one year and compared with 190 scans which were performed post-FTS introduction over two years.
Results: Significant stenoses were identified in 24 scans (22%) before FTS, of which, 6 (25%) had no intervention, 15 (62.5%) had interventions and 3 (12.5%) were occluded by the time of intervention. The median delays from duplex to referral to radiology and from duplex to intervention were 32 and 56 days respectively. After the introduction of FTS, 35 scans were noted to have significant stenoses. Only 23 (66%) of them had interventions. The median delays from duplex scan to referral to radiology and from duplex to intervention were 0 and 20 days respectively. There was one graft (3%) occlusion after the introduction of FTS by the time of the angiogram compared with 3 (12.5%) in the pre-FTS group (p = 0.35).
Conclusions: Approximately 20% of the scans performed over one year for infra-inguinal bypass are at risk of failure. The FTS has reduced the time - delay from Duplex scan to referral to radiology and the number of occluded grafts. Further improvement is needed to reduce the delay between the referral and intervention