Intraoperative video angioscopy compared with arteriography during peripheral vascular operations

Area of Science:

• Vascular Surgery
• Medical Imaging
• Endoscopy

Background:

• Intraoperative assessment of peripheral vascular procedures is crucial for successful outcomes.
• Traditional angiography has limitations in providing real-time, detailed visualization during surgery.

Purpose of the Study:

• To evaluate the diagnostic and therapeutic utility of intraoperative angioscopy in peripheral vascular surgery.
• To compare the accuracy of angioscopy with conventional angiography for assessing bypass grafts and anastomoses.

Main Methods:

• A prospective study involving 67 vessels and 17 bypass grafts across various peripheral vascular operations.
• Utilized a flexible, fiberoptic endoscope with video projection for magnified intraoperative imaging.
• Compared angioscopic findings with preoperative and completion angiograms.

Main Results:

• Angioscopy revealed significant disparities with arteriography in 21% of cases, leading to management changes in 12.5%.
• Arteriography demonstrated a 12.5% false negative and 8% false positive rate compared to angioscopy.
• Angioscopy accurately assessed all anastomoses and was beneficial for monitoring embolectomy, with minimal complications (vasospasm).

Conclusions:

• Intraoperative angioscopy is a safe and accurate alternative for assessing peripheral vascular procedures.
• It enhances the monitoring of anastomotic results and the control of therapeutic interventions.
• Angioscopy provides superior real-time visualization compared to angiography in specific surgical contexts.