Operative color Doppler imaging (CDI) was performed during 57 vascular operations (24 carotid, 24 lower extremity, six renal artery, and three other operations), and its benefits were assessed in comparison to B-mode imaging. Pre-reconstruction operative CDI was used selectively in 18 operations, and post-reconstruction operative CDI was used routinely in all operations. In 16 operations (28.6%), post-reconstruction CDI diagnosed vascular defects such as intimal flaps (n = 4), anastomotic stenoses (n = 7), and in situ bypass arteriovenous fistulas (n = 4). Vascular defects at eight operations required immediate repair. Operative CDI had advantages over B-mode imaging in (1) detection of preoperatively unknown vascular abnormalities before reconstruction, (2) faster recognition of vascular defects after reconstruction, (3) unique ability to detect problems (i.e., arteriovenous fistulas) that were unidentifiable by B-mode imaging, and (4) provision of supplemental blood flow information.
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