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Zur Wertigkeit der intraoperativen Kontrollangiographie im femoro-popliteo-cruralen Bereich

The value of intraoperative arteriography in detecting complications of vascular surgery in the femoro-popliteal and crural region

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Summary

The intraoperative angiography was employed in 307 vascular reconstructive procedures (thrombendarterectomies (TEA)n = 107 = 34.8 %; Veinbypass (VBP)n = 145 = 47.2 %; fabric grafts (KBP)n = 44 = 14.4 %) within the femoro-popliteal and crural region. 11.7% unsuspected technical errors were detected (TEA 18.6 %; VBP 8.2 %; KBP: 6.8 %) by angiography and sucessfully revised prior to wound closure. Errors were most common after thrombendarterectomies followed by VBP and KBP. Revisions after immediate failures were performed successfully in 7.4 % (TEA: 8.4 %, VBP : 5.5 %, KBP: 6.8 %). Lesions on X-ray of questionable significance were accepted in 6.8%, and followed by 4 immediate occlusions (1.7%). In 3.6% of the angiogramms the film was not satisfactorily exposed from the technical point of view. We think intraoperative angiography is a valuable adjunct in peripheral vascular surgery helping to detect and correct technical errors.

Zusammenfassung

Die intraoperative Angiographie wurde bei 307 Operationen (Thrombendarteriektomie (TEA)n =107 = 34,8 %; Venenbypass (VBP)n = 145 = 47,2 %; Kunststoffbypass (KBP)n = 44 = 14,4 %, zusammengesetzte Rekonstruktionenn = 11 = 3,6 %) wegen chronisch obliterierender Arteriopathie im femoro-poplitealen und cruralen Bereich angewendet. Die kumulative Korrekturrate betrug 11, 7% (TEA: 18, 6%, VBP: 8,2%, KBP:6,8%); Fehler waren am häufigsten nach TEA gefolgt von VBP und KBP. Revisionen nach Sofortverschluß (SFV) verliefen in 7,4 % erfolgreich (TEA: 8,4 %; VBP: 5,5 %, KBP: 6,8 %). Bei technisch einwandfreiem Angiogramm gelangen Korrekturen in 13,1 % nicht (TEA: 11,2 %; VBP: 13,8 %; KBP: 13,6 %). Röntgenbefunde fraglicher Wertigkeit wurden in 6,8 % akzeptiert, 4 Sofortverschlüsse wurden gezählt (1,7%). In 3,6% der Fälle war das Arteriogramm technisch nicht einwandfrei. Die intraoperative Kontrollangiographie wird auf Grund der vorliegenden Erfahrung als wertvolles Hilfsmittel zur Qualitätskontrolle gefäßrekonstruktiver Eingriffe empfohlen. Technische Fehler können entdeckt und sofort behoben werden.

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Authors and Affiliations

  1. Chirurgische Universitätsklinik in Wien, Alserstraße 4, A-1090, Wien

    G. Kretschmer, P. Polterauer, O. Wagner, M. Winter & F. Piza

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  1. G. Kretschmer
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  2. P. Polterauer
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  3. O. Wagner
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  4. M. Winter
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  5. F. Piza
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Kretschmer, G., Polterauer, P., Wagner, O. et al. Zur Wertigkeit der intraoperativen Kontrollangiographie im femoro-popliteo-cruralen Bereich. Langenbecks Arch Chiv 354, 89–100 (1981). https://doi.org/10.1007/BF01271156

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  • DOI: https://doi.org/10.1007/BF01271156

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