[Angioscopy in peripheral vascular surgery]

At Saint-Luc's Hospital of Montreal, between January 1, 1990 and February 1, 1991, 47 angioscopic procedures were done in 43 patients submitted to peripheral vascular reconstructions. The purpose of the study was to evaluate the role of angioscopy during those procedures. The operations were as follows: twenty femoropopliteal bypasses done with reversed saphenous vein, 15 done with in situ saphenous veins and 10 done with synthetic grafts. Two patients had popliteal embolectomies. Seventeen percent of the cases showed technical problems with the use of controlled angioscopy and were subsequently corrected. Three residual valves and one unsuspected venous stenosis were found in 15 in situ grafts, for a total of 27% correctible defects. In the reversed saphenous group, one case of venous sclerosis and one case of anastomotic stenosis were found for a total of 10%. For the synthetic grafts group we found an intimal flap distal to the anastomosis in one case (10%). Finally, we found a significant residual clot in one case (50%) after embolectomy. The technique of angioscopy is simple, the equipment reliable, and the learning period is short. Angioscopy is a very useful approach and should be readily available in the armamentarium of every vascular surgeon.