Use of thermal imager in preparation of non-reversed autovein for femoropopliteal bypass grafting

Krepkogorsky N.V., Ignatyev I.M., Bredikhin R.A.

Interregional Clinical and Diagnostic Centre, Department of Cardiovascular and Endovascular Surgery of the Faculty of Advanced Training and Professional Retraining of Specialists, Kazan State Medical University of the RF Ministry of Public Health, Kazan, Russia

Presented herein is an original method of preparing a bypass graft (a non-reversed autovein for femoropopliteal and femorotibial bypass grafting) and assessment of quality of valvulotomy using a thermal imager.

The study included a total of 31 patients. All patients subdivided into 2 groups were subjected to bypass grafting operations with the use of a non-reversed autovein. In group 1 (n=16) prior to applying a bypass graft we assessed its patency with the use of an original method by means of a thermal imaging camera. In group 2 (n=15) assessment of graft patency after destruction of valves was not performed.

In group 1 there were no bypass graft thromboses in the postoperative period, whereas three (20%) patients in group 2 developed bypass graft thrombosis within the first 24 postoperative hours, requiring repeat operation. Bypass graft thrombosis was caused in all cases by insufficiently destroyed valves of the venous transplant.

There were no lethal outcomes within 1 year postoperatively. Control ultrasonographic examination after 1 year revealed bypass graft thrombosis in two (13.3%) patients in group 2, leading to the development of critical ischaemia and gangrene in one (6.6%) of these patients and later on requiring limb amputation at the level of the femur.

A conclusion drawn is that thermal imaging makes it possible to intraoperatively assess quality of valvulotomy in using a non-reversed autovein as a bypass graft and to improve the results of surgical treatment.

KEY WORDS: femoropopliteal bypass grafting, valvulotomy, thermal imaging examination, lower limb artery atherosclerosis, chronic venous insufficiency.

P. 123

« Back