Immediate occlusions dependent on the type of reconstruction

In 507 reconstructive procedures on patients with chronic occlusions, we saw 4.1% immediate occlusions. We performed 409 thrombendarteriectomies, 40 dacron grafts, and 32 venous bypasses. As cause of the immediate occlusion, we found in 23 cases a dissection of the intima in the distal segment of the restored artery, in one case a bleeding from a perforation was discovered. Intimal dissection was found mostly after orthograde thrombendarteriectomy of the femoral and popliteal artery. The results of orthograde TEA could be improved by intraoperative angiography or direct opening of the distal popliteal artery. Intimal dissection after bypass operations are generally the result of technical errors.