[Peroperative angiography in reparative surgery of the lower limbs. Apropos of experience with 1099 cases].
The authors report their experience of per-operatory angiography in a series of 1,099 cases over 13 consecutive years. The main interest is the limitation in the rate of early reintervention, which frequently causes morbidity and mortality in this type or surgery. The serial nature of the technique is emphasized, and is most comparable to pre-operatory exploration. The various technical details are specified. Some hemodynamic troubles noted during injection (aortography) contraindicate the method in high-risk subjects. The main indications are, above all, control of restorative acts, but also a per-operatory diagnosis of a lesion, and the assessment of blood stream at a lower level. The results are morphological and the various anomalies discovered are reviewed, with iconography, in relation to each type of surgical act (disobliteration, bypass). In situ bypasses are considered separately. The data are also hemodynamic, and justify the six successive X-ray film technique. Deblocking (embolectomy with a balloon catheter) and endarterectomies were found to give more technical imperfections than bypasses. The rate of extemporaneous corrections tripled during the second period (1978 to 1986), and this was no doubt due to an extension in operative indications (19% versus 6% at the beginning). Dacron bypasses (fibrinous debris) and in situ bypasses (detection of anatomical abnormalities, location of shunts) were more often incriminated in immediate reinterventions than Dardik homografts or PTFE.
Courchia
G
G
Service de Chirurgie Vasculaire, Hôpital Pellegrin, Bordeaux.
Serise
J M
JM
Moreau
J L
JL
Delorge
C
C
Winnock
S
S
Boissieras
P
P
D000792:Angiography / Q000379:methods*; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy; D006801:Humans; D007432:Intraoperative Period; D007866:Leg / Q000098:blood supply*
L'angiographie per-opératoire dans la chirurgie de restauration des membres inférieurs. A propos d'une expérience de 1,099 cas.