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Annals of Vascular Surgery

, Volume 7, Issue 1, pp 33–38 | Cite as

Intraoperative B-mode ultrasonography is a useful adjunct to peripheral arterial reconstruction

  • Timothy-F. Kresowik
  • Jamal J. Hoballah
  • William J. Sharp
  • Edwin V. Miller
  • John D. Corson
Papers From The Peripheral Vascular Surgery Society
  • 2 Downloads

Abstract

We used an ultrasound imaging system with a 10 MHz probe during 118 vascular procedures. These procedures included 56 cerebrovascular, 38 infrainguinal, 16 renal, 4 mesenteric, and 4 aortic reconstructions. In 29 procedures, intraoperative ultrasonography was used to supplement or replace preoperative arteriography to better define the extent of disease for the optimal placement of an anastomosis or to determine the need for an additional reconstructive procedure. In 106 cases, ultrasonography was used for postreconstruction assessment. Of the 21 (20%) defects found, 11 (10%) were deemed important enough to warrant correction. Defects were significantly more common following endarterectomy procedures (p <0.01). All 11 of the major defects were successfully repaired, and neither the corrected defects nor the 10 uncorrected minor defects were associated with postoperative complications. Patients (with and without defects) underwent routine early postoperative follow-up assessment of the technical adequacy of their reconstruction using color duplex imaging; no residual defects were discovered. Two (2%) postoperative occlusions (one femorofemoral and one aortorenal bypass) occurred without a technical defect noted on reexploration. This clinical experience demonstrates that B-mode ultrasonography can supplement or replace preoperative arteriography in selected cases and is a valuable technique for identifying defects intraoperatively so that they can be immediately corrected.

Keywords

Arterial Reconstruction Residual Defect Corrected Defect Vascular Procedure Color Duplex 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Bredenberg CE, Iannettoni M, Rosenbloom M, et al. Operative angiography by intraarterial digital subtraction angiography: A new technique for quality control of carotid endarterectomy. J Vasc Surg 1989;9:530–534.CrossRefPubMedGoogle Scholar
  2. 2.
    White GH, White RA, Kopchok GE, et al. Intraoperative video angioscopy compared with arteriography during peripheral vascular operations. J Vasc Surg 1987;6:488–495.CrossRefPubMedGoogle Scholar
  3. 3.
    Barnes RW, Nix ML, Nichols BT, et al. Recurrent versus residual carotid stenosis: Incidence detected by Doppler ultrasound. Ann Surg 1986;203:652–660.PubMedGoogle Scholar
  4. 4.
    Sigel B, Coelho JCU, Flanigan DP, et al. Detection of vascular defects during operation by imaging ultrasound. Ann Surg 1982;196:473–480.PubMedGoogle Scholar
  5. 5.
    Schwartz RA, Peterson GJ, Noland KA, et al. Intraoperative duplex scanning after carotid artery reconstruction: A valuable tool. J Vasc Surg 1988;7:620–624.CrossRefPubMedGoogle Scholar
  6. 6.
    Reilly LM, Okuhn SP, Rapp JH, et al. Recurrent carotid stenosis: A consequence of local or systemic factors? The influence of unrepaired technical defects. J Vasc Surg 1990;11:448–460.CrossRefPubMedGoogle Scholar
  7. 7.
    Okuhn SP, Reilly LM, Bennett JB, III et al. Intraoperative assessment of renal and visceral artery reconstruction: The role of duplex scanning and spectral analysis. J Vasc Surg 1987;5:137–147.CrossRefPubMedGoogle Scholar
  8. 8.
    Hansen KJ, O'Neil EA, Reavis SW, et al. Intraoperative duplex sonography during renal artery reconstruction. J Vasc Surg 1991;14:364–374.CrossRefPubMedGoogle Scholar
  9. 9.
    Cull DL, Gregory RT, Wheeler JR, et al. Duplex scanning for intraoperative assessment of infrainguinal arterial reconstruction: A useful tool? Am Vasc Surg 1992;6:20–24.CrossRefGoogle Scholar
  10. 10.
    Sawchuk AP, Flanigan DP, Machi J, et al. The fate of unrepaired minor technical defects detected by intraoperative ultrasonography during carotid endarterectomy. J Vasc Surg 1989;9:671–676.CrossRefPubMedGoogle Scholar
  11. 11.
    Flanigan DP, Douglas DJ, Machi J, et al. Intraoperative ultrasonic imaging of the carotid artery during carotid endarterectomy. Surgery 1986;100:893–898.PubMedGoogle Scholar
  12. 12.
    Moore WS, Martello JY, Quinones-Baldrich WJ, et al. Etiologic importance of the intimal flap of the external carotid artery in the development of postcarotid endarterectomy stroke. Stroke 1990;21:1497–1502.PubMedGoogle Scholar
  13. 13.
    Gilbertson JJ, Walsh DB, Zwolak RM, et al. A blinded comparison of angiography, angioscopy, and duplex scanning in the intraoperative evaluation of in situ saphenous vein bypass grafts. J Vasc Surg 1992;15:121–129.CrossRefPubMedGoogle Scholar

Copyright information

© Annals of Vascular Surgery Inc 1993

Authors and Affiliations

  • Timothy-F. Kresowik
    • 1
  • Jamal J. Hoballah
    • 1
  • William J. Sharp
    • 1
  • Edwin V. Miller
    • 1
  • John D. Corson
    • 1
  1. 1.From the Vascular Surgery Section, Department of SurgeryThe University of Iowa Hospitals and ClinicsIowa City

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