Intraoperative quality control in vascular surgery

Since graft patency is the predominant predictor of long-term survival after vascular surgery, intraoperative graft patency control is of major importance for improving quality assurance. Intraoperative quality control is of major importance to obtain good short- and longterm results and to eliminate the need for reoperation. Currently there is no standardized approach and intraoperative quality control is not performed routinely by most surgeons. The most commonly used intraoperative assessment techniques include arteriography, duplex ultrasonography, angioscopy and transit-time flow measurement (TTFM). Fluorescent angiography (FA) using the dye indocyanine green (ICG) is a novel noninvasive technology for intraoperative visualization and documentation of vessels, bypass grafts, and perfusion with an infrared sensitive imaging device, so far validated for quality control in coronary bypass surgery. FA and TTFM are methods for quantitative assessment of blood flow measurement, which are currently exclusively used as intraoperative quality control in cardiac bypass surgery. Up to now, there are no experiences published for peripheral vascular reconstructions. However, transposition and implementation of these techniques seem to be valuable and useful. Therefore further studies for intraoperative quality control in vascular surgery are necessary.