Clinically unsuspected complications of arterial surgery shown by post-operative digital substraction angiography

Intravenous digital subtraction angiography was performed within 20 days of 678 vascular reconstructions as a routine post-operative evaluation. After 339 carotid endarterectomies, 34 patients showed a stenosis of greater than 30% and six occlusions were seen. In 157 patients after aortic aneurysm repair, we found five anastomotic aneurysms and seven stenoses of greater than 30%. After aortic bypass surgery, 77 patients were evaluated and nine stenoses were found; no anastomotic aneurysms were seen. In 105 patients with femoro-distal bypass procedures, occlusion was reported in 11 cases and stenosis in 13 cases. One patient had two anastomotic aneurysms. To summarize, major abnormalities were present in 81 cases (12.7%) and consisted of 59 stenoses of greater than 30%, 17 occlusions and six patients with anastomotic aneurysms. Most of these were unexpected and were reason for more critical follow-up or re-operation.