Operative color Doppler imaging for vascular surgery

Abstract

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.

Operative color Doppler imaging for general surgery

“…From the results of this study, we have identified five advantages of operative COl over operative B·mode imaging during general surgical operations: (1) detection and localization of relatively small blood vessels that are impossible or difficult to identify by B-mode imaging or by surgical exploration; (2) rapid and definitive distinction of blood vessels from other hypoechoic areas such as tissue spaces, ducts, and cystic lesions; (3) easier determination of the relation of tumor or other lesions to vascular structures, such as vascular invasion of carcinoma; (4) confirmation of adequate blood flow to critical organs after comple· tion of major surgical procedures; and (5) more prompt and dearer needle localization for guidance of needle placement by motion marking.ta Identification of blood vessels, which must be divided or protected, is an essential aspect of any sur· gical operation. Operative B-mode imaging can identify relatively larger vessels before their exposure.…”

“…or difficult to identify by 8·mode imaging, (2) rapid and definitive distinction of blood vessels from other hypoechoic areas, such as tissue spaces and ducts, (3) determination of the relation of tumors to vascular structures such as vascular invasion of carcinoma, (4) confirmation of blood flow to organs after surgical procedures, and (5) clearer needle localization for guidance of needle placement by color motion marking. KEY WORDS: Color Doppler imaging; Operative ultrasonography; General surgery.…”

História da ultra-sonografia intra-operatória

“…A USIO com Doppler foi iniciada nas cirurgias cardiovasculares, na medida em que possibilitava o estudo do fluxo sanguíneo (34) . Alguns trabalhos (Machi et al (35) ) demonstraram a utilidade da adição do Doppler colorido nos exames de USIO em modo B, durante as cirurgias carotí-deas, vasculares periféricas e após revascularização renal. Esses autores relataram que o Doppler tornava as cirurgias mais rá-pidas e melhorava a detecção de alterações vasculares após a reconstrução.…”