A comparative study of intraoperative angioscopy and completion arteriography following femorodistal bypass.

A prospective comparison of the findings on standard completion arteriography with those seen using videoangioscopy was done following 49 cases of "femorodistal" bypass grafting in 47 patients. The two techniques were compared with respect to the detection of technical defects, modification of the surgical procedures, early graft patency (72 hours), and complications. Completion arteriography was specific (95%) but only moderately sensitive (67%) compared with angioscopy for detection of technical problems. Following angioscopy, significant alterations in the surgical procedure were noted in 5 (10%) of the 49 cases. Early graft failure occurred in 3 (6.1%) cases but none were identifiably due to technical problems. Four patients suffered postoperative myocardial infarctions, 2 (4.2%) of which were fatal; no patients had contrast-induced allergies or renal failure. Angioscopy was measurably more accurate for the detection of technical problems than completion arteriography, but offered little information about distal arterial anatomy that may have an impact on graft patency or the use of antithrombotic therapy.

[1]  R. Lees,et al.  Routine intraoperative angioscopy in lower extremity revascularization. , 1989, Archives of surgery.

[2]  B. Chang,et al.  Resurrection of the In Situ Saphenous Vein Bypass: 1000 Cases Later , 1988, Annals of surgery.

[3]  W S Grundfest,et al.  Intraoperative decisions based on angioscopy in peripheral vascular surgery. , 1988, Circulation.

[4]  J. S. Yao,et al.  Improved long-term patency of infragenicular polytetrafluoroethylene grafts. , 1988, Journal of vascular surgery.

[5]  T. Matsumoto,et al.  Intimal response of saphenous vein to intraluminal trauma by stimulated angioscopic insertion. , 1987, Journal of vascular surgery.

[6]  J. S. Yao,et al.  Technical defects as a cause of early graft failure after femorodistal bypass. , 1987, Archives of surgery.

[7]  J. Seeger,et al.  Angioscopy as an adjunct to arterial reconstructive surgery: a preliminary report. , 1986, Journal of vascular surgery.

[8]  J. Mehigan,et al.  Video angioscopy as an alternative to intraoperative arteriography. , 1986, American journal of surgery.

[9]  J. Triller,et al.  The fate of femoropopliteal and femorodistal bypass grafts in relation to intraoperative flow measurement: an analysis of 100 consecutive reconstructions for limb salvage. , 1986, Surgery.

[10]  D. Flanigan,et al.  Results of arterial reconstruction of the foot. , 1986, Archives of surgery.

[11]  J. P. Meyer,et al.  Early experience with in situ saphenous vein bypass for distal arterial reconstruction. , 1986, Surgery.

[12]  D. Bandyk,et al.  A low flow velocity predicts failure of femoropopliteal and femorotibial bypass grafts. , 1985, Surgery.

[13]  H. L. Young,et al.  In situ vein bypasses to distal tibial and limited outflow tracts for limb salvage. , 1984, Surgery.

[14]  R. Zierler,et al.  Detection of technical error during arterial surgery by pulsed Doppler spectral analysis. , 1984, Archives of surgery.

[15]  D. Brewster,et al.  Femoropopliteal graft failures. Clinical consequences and success of secondary reconstructions. , 1983, Archives of surgery.

[16]  B. Sigel,et al.  Detection of Vascular Defects During Operation by Imaging Ultrasound , 1982, Annals of surgery.

[17]  J. S. Yao,et al.  Correlation of foot arterial anatomy with early tibial bypass patency. , 1981, Surgery.

[18]  A. Clowes,et al.  Secondary femoropopliteal reconstruction. , 1981, Annals of surgery.

[19]  F. Reichle,et al.  Redo surgery for graft failure. , 1978, American journal of surgery.

[20]  W. Edwards,et al.  Management of early postoperative complications of arterial repairs. , 1977, Archives of surgery.

[21]  Towne Jb,et al.  Vascular endoscopy: useful tool or interesting toy. , 1977 .

[22]  J. Craver,et al.  Hemorrhage and thrombosis as early complications of femoropopliteal bypass grafts: causes, treatment, and prognostic implications. , 1973, Surgery.

[23]  H. J. Terry,et al.  The relationship between blood‐flow and failure of femoropopliteal reconstructive arterial surgery , 1972, The British journal of surgery.

[24]  J. Mannick,et al.  Hemodynamics of arterial surgery in atherosclerotic limbs. I. direct measurement of blood flow before and after vein grafts. , 1966, Surgery.