Doppler ultrasound of the saphenous vein as a bypass. Detection of arteriovenous fistulae

Abstract

In 13 patients who underwent a femorodistal revascularisation with an in situ saphena vein graft and who had been operated on by angioscopic technique, intraoperative angiography and postoperative colour-coded Doppler sonography and i.v./i.a. digital subtraction angiography (DSA) were performed to detect arteriovenous fistulas (AV fistulas). In intraoperative completion angiography no AV fistulas were seen. Colour-coded Doppler sonography and DSA studies performed three to five days postoperatively revealed AV fistulas in 8 patients. The fistulas could be exactly located by sonography, and, if confirmed haemodynamically significantly by i.v./i.a. DSA, they were marked on the skin and ligated. In the detection of AV fistulas in in situ saphenous vein grafts operated by angioscopic technique colour-coded doppler sonography and i.v./i.a. DSA showed equivalent results. In the detection of connections of AV fistulas to the deep draining veins the i.v./i.a. DSA was superior.