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[Reliability and risks of angiography in microsurgery].

K D Wolff1, R Sörensen

  • 1Klinik für Kiefer- und Plastische Gesichtschirurgie Berlin.

Deutsche Zeitschrift Fur Mund-, Kiefer- Und Gesichts-Chirurgie
|July 1, 1990
PubMed
Summary

Preoperative angiography aids microvascular surgery planning, but can complicate procedures due to contrast medium. Routine use is advised only for altered surgical sites, with a 2-day washout interval before surgery.

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Area of Science:

  • Vascular Surgery
  • Medical Imaging

Background:

  • Angiography is a standard imaging technique for deep iliac circumflex, inferior epigastric, and external pudendal arteries.
  • Smaller superficial vessels (superficial iliac circumflex, superficial epigastric, muscular branches) are visualized in only 70-90% of cases.
  • Vascular calcification in the femoral artery can impede cannulation of smaller arterial origins.

Purpose of the Study:

  • To evaluate the utility and limitations of preoperative angiography in microvascular surgery.
  • To identify potential complications associated with contrast medium use in microvascular procedures.

Main Methods:

  • Review of angiography's effectiveness in visualizing various arterial vessels.
  • Analysis of complications arising from contrast medium presence before microvascular anastomoses.

Main Results:

  • Angiography reliably visualizes larger deep arteries but struggles with smaller superficial vessels.
  • Contrast medium remnants can compromise vessel patency and complicate anastomotic procedures.
  • High viscosity of contrast medium may lead to stasis in microvasculature.

Conclusions:

  • Preoperative angiography is valuable for treatment planning in microvascular surgery.
  • Routine angiography is recommended only for cases involving previously altered surgical sites.
  • A minimum 2-day interval between angiography and surgery is crucial for complete contrast medium washout.

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