[Indicatory and technical faults as cause of postoperative complications in arterial surgery]

In all vascular surgery the technic and quality of the first operation is a factor of decisive importance for the long-term results. The need to perform a second or third operation considerably reduces the chances of success. Routine use of an intra-operative control method like arteriography or vascular endoscopy, makes a decisive contribution in the peripheral circulation of the limbs to the immediate detection of errors of operative technic and their correction during the same operation. A change of indication for occlusive processes in the femoropopliteal branch is evident: patients with claudication should be treated with profunda revascularisation combined with lumbal sympathectomy and patients with rest-pain and necrosis should be treated with venous autografts using a microsurgical technic. To avoid deep wound infections the selection of an incision line which does not damage the lymphatic channels, particularly in the groin, the short duration of operations and the use of a purely instrumental operative technic with minimal damage to the tissues are of decisive importance. Examples are used to illustrate errors of indication and technic and the post-operative sequelae of such errors.