Intraoperative angiography in arterial surgery

Area of Science:

• Vascular Surgery
• Diagnostic Imaging

Background:

• Vascular reconstruction surgery for aorta, iliac, femoral, and carotid arteries is complex.
• Assessing surgical success intraoperatively is crucial for long-term patency.

Purpose of the Study:

• To evaluate the utility of intraoperative angiography in assessing vascular reconstructions.
• To determine the impact of intraoperative findings on postoperative outcomes.

Main Methods:

• Intraoperative angiography was performed in 136 cases of arterial reconstruction.
• Pathological findings were identified and correlated with surgical revisions and follow-up outcomes.
• Comparison of outcomes between revised and non-revised cases with abnormal angiograms.

Main Results:

• 39 cases (28.7%) showed unexpected pathological angiograms, including non-occluding thrombosis and intimal damage.
• Immediate reexploration and revision of abnormal angiograms led to high success rates at follow-up (1-24 months).
• Non-revised reconstructions with pathological angiograms frequently failed early postoperatively; normal angiograms yielded excellent results.

Conclusions:

• Intraoperative angiography is a valuable tool for assessing vascular reconstructions during surgery.
• Prompt surgical revision based on intraoperative angiography findings improves long-term patency.
• Intraoperative angiography should be utilized more frequently in vascular surgery.