Multifactorial effects on the patency rates of forearm arterial repairs

It is clear that the late clinical symptomatology and the patency of forear m arterial repairs have been contradictory. This study, during which the re lationship between the symptomatology and patency has been studied, explore s the influence of the local hemodynamic changes and the effect of microsur gical technique on patency rates. Thirty-five patients with a total of 44 a rterial injuries were treated. Hemodynamic studies were done intraoperative ly, and all patients were evaluated postoperatively with a neurologic, vasc ular, clinical examination and by radiodiagnostic methods. An overall paten cy of 77.2% was found. Color-Doppler ultrasonography (CDU) failed by 14.2% as compared with angiography, which did not fail. High blood pressure on th e distal stump led to significantly reduced patency rates. Eight patients w ithout nerve problems were found to be symptomatic as a result of the poor patency rate. Many factors are observed to influence patency rate. The nonp atent forearm artery can be symptomatic in anatomically and hemodynamically varied hands, CDU was more reliable for hemodynamic evaluation; conversely , angiography was more dependable for arterial morphology. The results of t his study suggest that to correlate the clinical symptomatology and the pat ency rates, all arterial repairs should be assessed both clinically and rad iodiagnostically. (C) 2001 Wiley-Liss, Inc.