[Evaluation of the venous network before arterial revascularization surgery].

Correct evaluation of the venous network before arterial revascularization is required to avoid unsuccessful explorations, underestimation of calibre because of spastic reactions to dissection and use of defective veins with unrecognized parietal or intraluminal lesions. The homolateral internal saphenous vein cannot be used in 10 to 30% of cases. Success of venous bypass is 30 to 40% greater than with prosthetic implants. Other veins can be used including the contralateral internal saphenous vein, external saphenous veins and veins from the upper limbs. Clinical evaluation is insufficient. Phlebography provides good results but is an aggressive exploration with certain limitations compared with duplex Doppler. Its potential complications are also absent with ultrasound exploration. Duplex Doppler is thus the first-line choice. Close coordination between the angiologist and the surgeon is essential to compare the exact measurements obtained preoperatively and the surgical findings, particularly concerning the venous calibre. Correction coefficients may then be established.