Significance of Arterial Defects on Completion Arteriograms Following Infrainguinal Bypasses

Intraluminal filling defects of the runoff arteries, which were transient in most cases, are frequently observed on completion arteriograms after crural arterial reconstructive proce dures. However, the incidence, fate, and significance of these changes have yet to be clarified. Completion arteriograms of 108 bypasses were evaluated retrospectively. The incidence of intraluminal defects of runoff arteries was examined by measuring the internal diameter on completion arteriograms and its relationship to the distal anasto motic site, underlying disease, and time the artery was ischemic, and the results of intra operative magnetic flowmetry were analyzed. These changes were compared with those revealed by subsequent postoperative arteriography. The incidence of arterial defects was 46% (50/108) and was higher in bypasses to more distal arteries (P<0.0001) and Buerger's disease patients (P<0.0001). Ninety percent (45/50) were transient. Postreconstructive flowmetry reflected the severity of intraluminal defects of runoff arteries; however, the fates of these changes could not be predicted by use of completion arteriography or intraoperative magnetic flowmetry.