Intraoperative renal duplex sonography: a valuable method for evaluating renal artery reconstructions.
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.
van Weel
V
V
Department of Vascular Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
van Bockel
J H
JH
van Wissen
R
R
van Baalen
J M
JM
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