Intraoperative prereconstruction arteriography.

Intraoperative arteriography was performed in 57 patients undergoing arterial reconstructive surgery of the lower extremity prior to selection of the site for the distal anastomosis. In 42 patients (74%), this procedure proved to be of significant benefit. Prereconstructive intraoperative arteriography influenced surgery for seven patients in the following ways: (1) two patients had visualization of vessels not demonstrated on the preoperative arteriogram; and (2) five patients had demonstration of occlusive disease that favored selection of a more distal site of anastomosis. In the remaining 35 patients, the tibial vessels and arch were visualized more clearly, so that the degree and extent of disease were better appreciated. This may have important prognostic significance. On postreconstructive arteriography, an additional five patients were shown to have an anastomotic defect that was corrected in the operating room. Intraoperative arteriography is a rapid, safe, and simple procedure that should be considered as an adjunct in reconstructive surgery of the lower extremity.