Detection of technical error during arterial surgery by pulsed Doppler spectral analysis.
Pulsed Doppler spectral analysis of midstream flow was compared with arteriography in 90 patients following carotid endarterectomy (N = 60) or lower-extremity bypass grafting (N = 30) for the detection of unsuspected technical error. Spectral changes in the velocity waveform indicating flow disturbance were identified in the endarterectomy or anastomotic sites of 11 patients (12%). All were associated with an anatomic defect apparent on arteriography. The revision of major defects in six patients (7%) corrected the flow disturbance. The absence of flow disturbance in 79 patients (88%) predicted a technically satisfactory arterial reconstruction. Intraoperative assessment by pulsed Doppler spectral analysis is a noninvasive, rapid, and accurate method for detecting technical errors during arterial surgery. The high sensitivity of this method makes it suitable for use as a screening test, resulting in the selective use of operative arteriography.
D000792:Angiography; D001158:Arteries / Q000293:injuries* / Q000601:surgery; D001783:Blood Flow Velocity; D002561:Cerebrovascular Disorders / Q000517:prevention & control; D004691:Endarterectomy / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications; D013057:Spectrum Analysis; D013927:Thrombosis / Q000517:prevention & control; D014463:Ultrasonography