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Updated: May 23, 2026
A Training and Testing System for Performing Vascular Reconstruction In Vitro
Published on: October 26, 2019
Intraoperative quality control in vascular surgery
S Wipper1, C Detter, C Lohrenz
1Department of Vascular Medicine, Vascular Surgery Endovascular Interventions, Angiology University Heart Center Hamburg-Eppendorf, Hamburg, Germany.
Insights
Intraoperative graft patency control is crucial for vascular surgery success. Novel techniques like fluorescent angiography show promise for improving patient outcomes and reducing reoperations.
Area of Science:
- Vascular Surgery
- Medical Imaging
- Quality Assurance
Background:
- Graft patency is the primary predictor of long-term survival in vascular surgery.
- Current intraoperative quality control methods lack standardization and routine use.
- Existing techniques include arteriography, duplex ultrasonography, angioscopy, and transit-time flow measurement (TTFM).
Purpose of the Study:
- To highlight the importance of intraoperative graft patency control in vascular surgery.
- To introduce novel noninvasive imaging technologies for quality assurance.
- To advocate for further research into implementing these techniques for peripheral vascular reconstructions.
Main Methods:
- Review of current intraoperative assessment techniques for vascular surgery.
- Introduction of fluorescent angiography (FA) using indocyanine green (ICG) as a novel visualization tool.
- Discussion of FA and TTFM as quantitative blood flow assessment methods.
Main Results:
- Fluorescent angiography (FA) is a validated, noninvasive technology for visualizing vessels and bypass grafts.
- FA and TTFM are currently used for quality control in cardiac bypass surgery.
- There is a lack of published experience with FA and TTFM in peripheral vascular reconstructions.
Conclusions:
- Intraoperative quality control is vital for optimizing short- and long-term results in vascular surgery.
- Fluorescent angiography (FA) and transit-time flow measurement (TTFM) show potential for peripheral vascular surgery.
- Further studies are necessary to establish the utility of these advanced techniques in vascular surgery.
Abstract:
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.
