Intra Operative Angiography

1.  Presented by- Dr Junish Singh Bagga
 Guide – Dr Nihar Ranjan Pradhan
Role of Intraoperative
Angiography in Vascular
Surgery

2.  The primary role of intraoperative angiography has been to
evaluate the status of the distal anastomosis after the vascular
reconstructive procedure has been carried out.

3. Arteriography

4.  Pre-reconstruction
Arteriography
 Seldom necessary
 To define run-off anatomy
 Potential site for anastomosis
Advantages

5.  More commonly used
 Immediate assessment of arterial reconstruction
 anastomotic stenosis,
 graft torsions or kinks
 unsuspected clots
 Incomplete thromboembolectomies and
endarterectomies,
Completion Arteriography

6.  Iodinated contrast agents
 Carbon dioxide Arteriography
 Gadolinium Angiography
Contrast material

7. Infrastructure
fixed/portable

8. Imaging techniques
 Fluoroscopy and data acquisition
 Rotational Angiography
 Digital subtraction angiography
 Fusion imaging and 2D/3D overlay
 Functional imaging in the OR

9.  No delay, Open surgery can immediately repair inadequate
endovascular results and vice versa
 Puncture complications related to angioplasty are eliminated
 Potential infectious complications of two separate
interventions are minimized
 Adjustment of drug therapy between the procedures is not
required
 Hospital stay is shortened and possibly cheaper
 Due to possible routine use of angiography and open flow
measurements at the end of the intervention, surgeons have
better means to control and verify renewed blood flow at all
levels and lesion sites.
Hybrid Operating Theatre

10.  Ascending venography –
 DVT/perforator status
 Descending venography –
 femoral vein
 Valvular incompetence
Venography

11.  Cost
 Radiation
 Contrast
Disadvantages

12. Thank-You