INTRAOPERATIVE CONTROL FOLLOWING FEMORODISTAL REVASCULARIZATION - ANGIOSCOPY IS SUPERIOR TO ANGIOGRAPHY

Intraoperative angioscopic control was performed in an early series of 27 patients undergoing peripheral vascular surgery. The majority were complex or re-do operations; reversed saphenous vein and PTFE-grafts were used as bypass material exclusively. Angioscopic findings were co mpared to conventional angiography with respect to the detection of te chnical problems leading to further surgical procedures. Angioscopy wa s feasable in 92.5%, it failed twice due to irrigation problems, which was before we used a dedicated angioscopy roller-pump. In 6 patients relevant findings requiring further surgical manipulations were only d etected angioscopically, in 2 patients such findings were detected by angioscopy as well as by angiography. Such findings included technical problems (graft rotation [n = 1], anastomotic narrowing [n = 2]), bal loon catheter injuries after thromboembolectomy (n = 2) and residual t hrombi after local thrombectomy (n = 3); 5 of these patients had under gone previous vascular procedures in the same operation field. After l ocal correction (n = 5) or placement of a new bypass (n = 3) there was no early graft failure. This early angioscopic experience confirmed p revious reports that satisfactory visualization and specific recogniti on of angiographically unsuspected problems after peripheral reconstru ctions can be obtained by intraoperative angioscopic control. This was seen very distinctively in more complex and re-do operations, which w e see as the cases most needing routine angioscopic control.