title: Intraoperative renal duplex sonography: a valuable method for evaluating renal artery reconstructions.
abstract: OBJECTIVE
  to determine the ability of duplex sonography to intraoperatively detect technical problems with renal artery reconstructions.
  
  
  METHODS
  retrospective evaluation of a standard protocol.
  
  
  METHODS
  the outcome of intraoperative duplex was compared with postoperative angiography, surface duplex, MRA, echo or direct inspection in case of re-exploration in 77 renal artery reconstructions in 62 patients. These included six extracorporeal reconstructions, eight and 17 reconstructions with an artery and autogenous vein respectively, 10 renal artery re-implantations in the aorta (prosthesis), 32 endarterectomies and four reconstructions of kidney transplant vessels.
  
  
  RESULTS
  intraoperative duplex was normal in 67/73 reconstructions with sufficient data. In six cases technical problems were revealed by intraoperative duplex and the reconstruction was re-explored. After re-exploration intraoperative duplex was normal in all cases. Confirmatory studies demonstrated normal results in 61/64 reconstructions with normal intraoperative duplex and abnormal results in 6/6 reconstructions with technical problems revealed by intraoperative duplex. Three reconstructions with normal intraoperative duplex occluded as demonstrated by angiography less than 2 weeks after surgery.
  
  
  CONCLUSIONS
  renal duplex sonography is a valuable method available for intraoperative detection of technical problems. Haemodynamic duplex data were less important than B-mode imaging in discriminating between normal and abnormal reconstruction.
authors.affiliation: Department of Vascular Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: V
authors.initials: V
authors.lastname: van Weel
authors.forename: J H
authors.initials: JH
authors.lastname: van Bockel
authors.forename: R
authors.initials: R
authors.lastname: van Wissen
authors.forename: J M
authors.initials: JM
authors.lastname: van Baalen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance