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The main study goal is to evaluate the influence of graft flow measurements on long\u2010term clinical outcomes in patients with chronic limb\u2010threatening ischemia (CLTI) undergoing bellow the knee (BTK) vein bypass surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 1st, 1999 and January 1st, 2006, 976 CLTI consecutive patients underwent lower extremity bypass surgery. When applying the exclusion criteria, 249 patients were included in the final analysis. Control measurements were performed at the end of the procedure. Patients were divided according to the mean (more\/less than 100\u00a0ml\/min) and diastolic graft flow (more\/less than 40\u00a0ml\/min) values in four groups. The primary endpoints were a major adverse limb event (male) and primary graft patency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the median follow\u2010up of 68\u00a0months, a group with the mean graft flow below 100\u00a0ml\/min and the diastolic graft flow below 40\u00a0ml\/min had the highest rates of male (\u03c7<jats:sup>2<\/jats:sup>\u2009=\u200936.60, DF\u2009=\u20091, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01, log\u2010rank test) and the worst primary graft patency (\u03c7<jats:sup>2<\/jats:sup>\u2009=\u200953.05, DF\u2009=\u20091, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01, log\u2010rank test).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with CLTI undergoing BTK vein bypass surgery, TTFM parameters, especially combined impact of mean graft flow less than 100\u00a0ml\/min and diastolic graft flow less than 40\u00a0ml\/min, were associated with an increased risk of poor long\u2010term male and primary graft patency.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-06046-y","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T15:02:46Z","timestamp":1615993366000},"page":"2280-2289","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of Bypass Flow Assessment on Long\u2010Term Outcomes in Patients with Chronic Limb\u2010Threatening Ischemia"],"prefix":"10.1002","volume":"45","author":[{"given":"Ilijas","family":"Cinara","sequence":"first","affiliation":[{"name":"Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia Dr Koste Todorovica 8 11000 Belgrade Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petar","family":"Zlatanovic","sequence":"additional","affiliation":[{"name":"Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia Dr Koste Todorovica 8 11000 Belgrade 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