Ameli F M, Rooney M S, St Louis E L, Stein M, Grosman H, Gray R R
Department of Vascular Surgery, Wellesley Hospital, University of Toronto, Canada.
Ann Vasc Surg. 1991 May;5(3):223-8. doi: 10.1007/BF02329377.
Between 1982 and 1986 intravenous digital subtraction arteriography was used to evaluate vascular grafts in 97 patients (54 males, 43 females). Indications included recurrent symptoms, absent or diminished pulses, a drop in Doppler pressure measurements, and clinical uncertainty with respect to graft patency. Problems identified included graft stenosis, stenosis of the anastomosis or its distal vessels, false aneurysm, arteriovenous fistula and emboli. Forty-eight operations were carried out following intravenous digital subtraction arteriography, and radiographic findings were verified surgically. Twice, intravenous digital subtraction arteriography did not show significant graft findings which were discovered at surgery. Thus intravenous digital subtraction arteriography showed a sensitivity of 95.8% and specificity of 100%. Complications following intravenous digital subtraction arteriography were: two patients developed urticaria, and one superficial thrombophlebitis. There were no cases of pulmonary edema or death. In conclusion intravenous digital subtraction arteriography is very useful in the diagnosis of graft-related problems if done on a selective basis looking at graft and anastomosis site only. Intravenous digital subtraction arteriography is done on an outpatient basis, has high sensitivity and specificity, good patient acceptance, is safe, fast and is less expensive than conventional arteriography.
1982年至1986年间，对97例患者（54例男性，43例女性）采用静脉数字减影动脉造影术评估血管移植物。适应证包括复发症状、脉搏消失或减弱、多普勒压力测量值下降以及关于移植物通畅性的临床不确定性。发现的问题包括移植物狭窄、吻合口或其远端血管狭窄、假性动脉瘤、动静脉瘘和栓子。静脉数字减影动脉造影术后进行了48次手术，影像学检查结果经手术证实。有两次，静脉数字减影动脉造影未显示出手术中发现的明显移植物病变。因此，静脉数字减影动脉造影的敏感性为95.8%，特异性为100%。静脉数字减影动脉造影术后的并发症有：2例患者出现荨麻疹，1例出现浅表血栓性静脉炎。无肺水肿或死亡病例。总之，静脉数字减影动脉造影术如果仅选择性地观察移植物和吻合口部位，对诊断移植物相关问题非常有用。静脉数字减影动脉造影术可在门诊进行，具有高敏感性和特异性，患者接受度良好，安全、快速且比传统动脉造影术费用更低。
