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Dennis F. Bandyk, MD; R. Eugene Zierler, MD; Brian L. Thiele, MD

Arch Surg. 1984;119(4):421-428.

Abstract
• Pulsed Doppler spectral analysis of midstream flow was compared with arteriography in 90 patients following carotid endarterectomy (N=60) or lower-extremity bypass grafting (N = 30) for the detection of unsuspected technical error. Spectral changes in the velocity waveform indicating flow disturbance were identified in the endarterectomy or anastomotic sites of 11 patients (12%). All were associated with an anatomic defect apparent on arteriography. The revision of major defects in six patients (7%) corrected the flow disturbance. The absence of flow disturbance in 79 patients (88%) predicted a technically satisfactory arterial reconstruction. Intraoperative assessment by pulsed Doppler spectral analysis is a noninvasive, rapid, and accurate method for detecting technical errors during arterial surgery. The high sensitivity of this method makes it suitable for use as a screening test, resulting In the selective use of operative arteriography.

(Arch Surg 1984;119:421-428)

Author Affiliations
From the Department of Surgery, Medical College of Wisconsin, Milwaukee, and the Surgical Services, Veterans Administration Medical Center, Wood, Wis (Dr Bandyk); and the Seattle VA Medical Center (Drs Zierler and Thiele).

Footnotes
Accepted for publication Nov 9, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 27, 1983.

Reprint requests to Department of Surgery, Milwaukee County Medical Complex, 8700 W Wisconsin Ave, Milwaukee, WI 53226 (Dr Bandyk).

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