Initial experience with the benefits of intraoperative angiography in surgery for peripheral arterial occlusive disease.

BACKGROUND This preliminary investigation evaluated the procedures for intraoperative angiography-assisted peripheral vascular revascularization in a teaching hospital. METHODS Between August 2000 and July 2001, intraoperative angiography with or without intervention was applied during surgery for peripheral arterial occlusive disease (PAOD) in 11 patients. Intraoperative angiography was employed to: (1) decide the best possible bypass graft outlet, (2) ensure the quality of the distal anastomosis of the bypass graft, (3) assist in the thrombectomy procedure, and (4) perform concomitant balloon angioplasty of vascular stenoses. Follow-up was conducted based on the clinical status, duplex scans, or angiographic surveillance. RESULTS The 7 procedures for chronic PAOD included 4 adjuvant intraoperative angioplasties. Amputation was required in 1 patient because the intraoperative angiography confirmed that no suitable distal bypass could be performed. The 4 procedures performed on acute ischemic limbs included 1 adjuvant intraoperative angioplasty and 1 arterial graft bypass. The immediate limb salvage rate was 81.8% (9/11), and the perioperative mortality rate was 8.3% (1/11). Additionally, the overall 1-year primary patency of the vessel/graft was 78% (7/9), immediate limb salvage was 81.8% (9/11), and 2-year survival was 81.8% (9/11). CONCLUSIONS Preliminary results presented herein confirm the variable usefulness of intraoperative interventional angiography in cases of peripheral arterial occlusive disease. From our results, we concluded that vascular surgeons should apply these endovascular therapeutic skills in their daily practice.