Intraoperative assessment of renal and visceral artery reconstruction: The role of duplex scanning and spectral analysis Steven P. Okuhn, M.D., Linda.

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Presentation transcript:

Intraoperative assessment of renal and visceral artery reconstruction: The role of duplex scanning and spectral analysis Steven P. Okuhn, M.D., Linda M. Reilly, M.D., John B. Bennett, Ph.D., Linda Hughes, R.N., Jerry Goldstone, M.D., William K. Ehrenfeld, M.D., Ronald J. Stoney, M.D. Journal of Vascular Surgery Volume 5, Issue 1, Pages 137-147 (January 1987) DOI: 10.1016/0741-5214(87)90204-7 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Spectral broadening index (SB) with renal artery waveforms used as examples. Left: SB = 0, systolic window greater than 75%. Center: SB = 1, systolic window = 50% to 75%. Right: SB = 2, systolic window less than 50%. Journal of Vascular Surgery 1987 5, 137-147DOI: (10.1016/0741-5214(87)90204-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Examples of normal intraoperative renal artery scans. a, Right renal artery after end-arterectomy. Note visible end point seen in middle of vessel (arrowhead). b, Left renal artery after ex vivo reconstruction with hypogastric arterial autogenous graft. Note branches reanastomosed to autogenous graft (arrowheads). c, Left renal artery after Dacron prosthetic bypass. d, Right renal artery after in situ reconstruction with hypogastric arterial autogenous graft. Journal of Vascular Surgery 1987 5, 137-147DOI: (10.1016/0741-5214(87)90204-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Examples of renal artery B-mode scans with minor (unrepaired) defects. a, Proximally based flap, less than 20% luminal narrowing (black arrow).b, Proximally based flap, less than 50% luminal narrowing (black arrow).c, Residual disease of proximal renal artery, less than 20% luminal narrowing (arrowheads).d, Residual aortic disease at renal artery orifice (arrowhead). Journal of Vascular Surgery 1987 5, 137-147DOI: (10.1016/0741-5214(87)90204-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Intraoperative duplex scan (a) shows 1.0 mm (small arrowhead) and 1.5 mm (arrowhead) proximal renal artery flaps with (b) no associated spectral abnormalities. Journal of Vascular Surgery 1987 5, 137-147DOI: (10.1016/0741-5214(87)90204-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Intraoperative duplex scan (a) and corresponding spectral pattern (b) obtained proximal to a proximally based, distal renal artery flap, more than 50%. Intraoperative duplex scan (c) and corresponding spectral pattern (d) obtained distal to same defect. Note changes in peak and mean frequencies. Journal of Vascular Surgery 1987 5, 137-147DOI: (10.1016/0741-5214(87)90204-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions