INTRAOPERATIVE COLOR DUPLEX SCANNING FOR SURGICAL TREATMENT OF LOWER EXTREMITIES ARTERIES

S.A. Dadvani, E.G. Artioukhina, K.B. Frolov, D.A. Ulianov

Widely known that almost half the cases of complications of the reconstructive operations caused by a technical defect or incorrect surgical tactics. Vessel re-exploration carries the added risk and technical difficulties. The objective of our research is to introduce the Intraoperation Color Duplex Imaging (IO CDI) for quality intraoperative monitoring in order to determine the technical defects and residual abnormalities and timely eradication of it. Since January 1999 IO CDI was performed on 19 patients with the atherosclerosis of lower limbs who underwent reconstructive operations: aortofemoral bypassing (9), endarterectomy (4), thrombectomy from bypasses (3), profundaplasty (3). The indications for IO CDI was the extensive atherosclerotic lesions of the reconstruction area and the necessity of reexploration. Following closure of the arteriotomy and restoration of blood flow IO CDI was performed. A high resolution 7-14 MHz transducer was used in all cases. B-mode imaging were used to identify the presence of intimal flaps, fronds etc., color flow mapping was used to define flow irregularity in this area. Noted that the quality of IO CDI was significant highly then conventional transcutaneous imaging. It make possible to detailing the abnormalities which was detected before operation. In the 7 cases (36,8%) IO CDI helped to detect the abnormalities which result to re-exploration: hemodinamically significant intimal flaps (1), residual stenosis (4), thrombi in the anastomosis area (2). All the defects was eradicated. IO CDI helped to avoid postoperative complications and reoperations. Thus the role of IO CDI may lie in modifications to surgical technique to produce technical refinements and thus improved outcomes for patients with the atherosclerosis of lower limb arteries.

KEY WORDS: intraoperative color duplex scaning.

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