Optimizing technical success of renal revascularization: The impact of intraoperative color-flow duplex ultrasonography Matthew J. Dougherty, MD, John.

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Presentation transcript:

Optimizing technical success of renal revascularization: The impact of intraoperative color-flow duplex ultrasonography Matthew J. Dougherty, MD, John W. Hallett, MD, James M. Naessens, MPH, Thomas C. Bower, MD, Kenneth J. Cherry, MD, Peter Gloviczki, MD, E.Meridith James, MD Journal of Vascular Surgery Volume 17, Issue 5, Pages 849-857 (May 1993) DOI: 10.1016/0741-5214(93)90034-J Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A, Intraoperative color-flow duplex ultrasonography of high-grade proximal left renal artery stenosis with peak systolic velocity of 5 m/sec, spectral broadening, and peak diastolic velocity of 3.0 m/sec. B, Same left renal artery after endarterectomy with widely patent lumen and normal velocity pattern including excellent diastolic flow. Journal of Vascular Surgery 1993 17, 849-857DOI: (10.1016/0741-5214(93)90034-J) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Types of major anatomic problems detected after bypass grafting or transaortic renal endarterectomy. Journal of Vascular Surgery 1993 17, 849-857DOI: (10.1016/0741-5214(93)90034-J) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Proximal left renal artery (ra) intimal flap (arrow) after transaortic (Ao) endarterectomy. B, Dampened spectral pattern in distal renal artery associated with proximal intimal flap. Peak systolic velocity of only 0.20 m/sec and minimal diastolic flow. Journal of Vascular Surgery 1993 17, 849-857DOI: (10.1016/0741-5214(93)90034-J) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 A, Widely patent proximal left renal artery in patient (Fig. 3) after correction of proximal intimal flap. B, Note improved peak systolic velocity (0.6 m/sec) with better diastolic flow. Journal of Vascular Surgery 1993 17, 849-857DOI: (10.1016/0741-5214(93)90034-J) Copyright © 1993 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions