Immediate assessment of vascular operations using segmental plethysmography.

Segmental plethysmography was used as a monitoring device during 156 direct vessel operations on the abdominal aorta and lower extremity vessels. Patency of distal vessels was assessed continuously and noninvasively before and during wound closure. A pulsatile response at wound closure was indicative of immediate and lasting patency in 94 per cent of extremities monitored. Plethysmographic detection of acute intraoperative occlusive phenomena allowed correction of such problems during the same procedure. The "chronic nonpulsatile" plethysmographic response, although not indicative of accidental occlusions in the majority of cases, portended a poor result, primarily on the basis of insufficient collateralization around pre-existing distal occlusive disease. Patients with such responses should be considered for additional efforts at revascularization. Segmental plethysmography is a reliable and objective method of immediate assessment of vascular patency and for prediction of long-term results.