The role of intra-operative duplex imaging in arterial reconstructions.
BACKGROUND
This study is a cost-benefit analysis of a less invasive method of intra-operative duplex imaging compared with the use of intra-operative angiogram (including C-arm fluoroscopy) in arterial reconstruction.


METHODS
From September 1994 to May 1995, 93 intra-operative duplex imaging studies were performed. Duplex scanning results were recorded for carotid endarterectomy (35), iliac balloon angioplasty and stent placement (12), and infra-inguinal bypass (46). Average cost and time were calculated for each type of study.


RESULTS
Thirty-four carotid endarterectomy patients (97%) had normal duplex findings. Three (9%) underwent intra-operative angiogram due to abnormal duplex findings and post-operative neurological deficit. In iliac balloon angioplasty and stent placement cases (12), both intra-operative duplex and C-arm post-stent angiography yielded comparable results in both normal (11) and abnormal (1) studies. In infra-inguinal bypass cases (46), 2 had abnormal duplex findings of the native vessels. Average time and cost required to perform intra-operative duplex studies is significantly less than that required for intra-operative angiogram or C-arm studies.


CONCLUSIONS
Compared with traditional intra-operative angiography, the use of intra-operative duplex imaging is less expensive, less invasive, quicker, and equally accurate when used as an adjunct to access surgical results of arterial reconstructions.
Yu
A
A
Vascular Surgical Service, Tacoma General Hospital, Washington, USA.
Gregory
D
D
Morrison
L
L
Morgan
S
S
D000800:Angioplasty, Balloon; D003365:Costs and Cost Analysis; D016894:Endarterectomy, Carotid; D006801:Humans; D007083:Iliac Artery; D007432:Intraoperative Period; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000191:economics; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000191:economics / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000191:economics