Femorodistal venous bypass evaluated with intravascular ultrasound.
OBJECTIVE
To evaluate the feasibility of intravascular ultrasound imaging during femorodistal venous bypass procedures to assess qualitative and quantitative parameters of the greater saphenous vein and to detect potential causes for (re)stenosis and/or occlusion.


METHODS
Intravascular ultrasound data obtained from 15 patients were reviewed and compared with angiographic data.


RESULTS
Intravascular ultrasound enabled differentiation between normal and thickened vein wall. Venous side-branches could be located. Intact valves could be differentiated from valves disrupted by valve cutting. Patent anastomoses could be distinguished from anastomoses with some degree of obstruction. Intravascular ultrasound imaging of the inflow and outflow tracts revealed obstructive lesions, not evidenced angiographically. Quantitative analysis revealed that the median normal vein wall thickness (tunica intima and tunica media) was 0.25 mm (range 0.17-0.40 mm). The distinct vein wall thickening encountered in three patients measured 0.82, 0.95 and 1.06 mm, respectively, and was associated with narrowing in two patients. In five of 15 patients intravascular ultrasound findings altered surgical management.


CONCLUSIONS
Intravascular ultrasound is able to assess qualitative and quantitative parameters of the venous bypass and has the potential to influence surgical management based on morphologic and quantitative data.
van der Lugt
A
A
Department of Vascular Surgery, University Hospital Dijkzigt Rotterdam, Erasmus University, The Netherlands.
Gussenhoven
E J
EJ
The
S H
SH
van Essen
J
J
Honkoop
J
J
Blankensteijn
J D
JD
du Bois
N A
NA
van Urk
H
H
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation; D016909:Tibial Arteries / Q000601:surgery; D018084:Ultrasonography, Interventional