Intraoperative Angiography in the Immediate Assessment of Arterial Reconstruction

Abstract

Forty-three unsuspected technical errors were detected by intraoperative angiography during 183 vascular reconstructions. All 43 were revised prior to wound closure and these revisions were successful in 34 or 79% of these cases. The wide variety of unsuspected defects shown on intraoperative angiography included incomplete thromboembolectomies and endarterectomies, anastomotic stenoses, graft torsions or kinks, and unsuspected clots. Errors in reconstruction were most common in thromboembolectomies, endarterectomies, and femoropopliteal bypass grafts. In spite of satisfactory postreconstructive intraoperative angiograms, 13 of the cases required revision during the postoperative period. Hemorrhage accounted for nine of these early failures. Intraoperative angiography is a useful, safe, and rapid adjunct in vascular reconstructive surgery.