[Reliability and risks of angiography in microsurgery].
Angiography is a reliable method for imaging the deep iliac circumflex, the inferior epigastric and the external pudendal artery. However, 10-30% of all arteriograms fail to visualize the superficial iliac circumflex, the superficial epigastric artery, and the muscular branch, whose lumina are generally 1 mm smaller at their origins. The reason for this may be associated with the cannulization of the vascular lumen for injection of the contrast medium (see below): while the cannula could be easily inserted in the larger vessels mentioned first, cannulation was occasionally complicated by calcareous deposits in the femoral artery which narrowed the lumen of the latter arteries at their origins. In smaller vessels angiography provides no conclusive information on degenerative alterations. Angiography performed immediately before microvascular anastomosing highly jeopardized the vessel's patency. Remnants of the highly viscous and sticky contrast medium that remain attached to the vascular wall complicate the technical procedure of anastomosing. In a free flap with its numerous anastomoses cut off, the medium's high viscosity may result in stasis first in the capillaries and ultimately in the trunk. According to the present results preoperative angiography is a useful method for treatment planning in microvascular surgery. However we should call for the routine application of this technique only in those cases, where the host or donor site has been changed in a previous surgical intervention. To ensure complete washout of the contrast medium, there should be an interval of at least 2 days between angiography and surgery.
Wolff
K D
KD
Klinik für Kiefer- und Plastische Gesichtschirurgie Berlin.
Sörensen
R
R
D000009:Abdominal Muscles / Q000098:blood supply; D000714:Anastomosis, Surgical; D000792:Angiography / Q000009:adverse effects; D000818:Animals; D000075202:Contraindications; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008297:Male; D008866:Microsurgery / Q000379:methods*; D051381:Rats; D011919:Rats, Inbred Strains; D015203:Reproducibility of Results; D012307:Risk Factors; D012611:Scrotum / Q000098:blood supply; D014844:Vulva / Q000098:blood supply
Aussagekraft und Risiko der Angiographie in der Mikrochirurgie.