AORTOILIAC RECONSTRUCTIVE SURGERY BASED UPON THE RESULTS OF DUPLEX SCANNING

Objective: to evaluate whether duplex scanning can replace angiography in patients operated for aortoiliac obstructive disease. Design: retr ospective. Materials and methods: between January 1995 and October 199 6, 44 patients underwent vascular surgery of the aortoiliac tract. The study population was divided into two,groups; patients operated upon the results of duplex scanning only and patients who also underwent an giography prior to surgery. The additional value of angiography and th e differences between both groups concerning unexpected peroperative f indings, early postoperative failures and the need for additional radi ological or surgical interventions in the first three postoperative mo nths were studied. Results: Duplex scan group: 22 patients were operat ed upon the results of duplex scanning only. In two patients surgical strategy had to be changed. Early postoperative graft occlusion occurr ed in one case. A haemodynamically significant graft stenosis within 3 months of surgery occurred in one patient. Duplex/angiography group: 22 patients underwent both duplex scanning and angiography. Six patien ts underwent diagnostic angiography after Jailed duplex scanning. In 1 0 patients angiography was part of percutaneous transluminal angioplas ty prior to surgery. In six patients angiograms were performed after s uccessful duplex scanning. Angiography failed in two patients and adde d information in four of 16 patients. Unexpected findings at operation occurred in four patients. Graft stenosis within 3 months was detecte d in three patients. Conclusion: after successful duplex scanning info rmation obtained by angiography has only a limited impact on therapeut ic decision-making. In the majority of patients vascular reconstructiv e surgery of aortoiliac arteries can be planned based or on duplex sca nning only.