Aorto-iliac reconstruction without arteriography

Background Duplex imaging has been shown to be as accurate as arteriography in detecting hemodynamically significant aorto-iliac stenosis or occlusions. Methods Review of the duplex scan and arteriogram reports for all primary aorto-iliac reconstructions performed during an 18-month period was undertaken. Deviations from the preoperatively planned procedure were determined. The role of the duplex scan on procedure selection was assessed. Results Of the 54 patients identified, 13 had both duplex scan and arteriography (group I), 30 had only arteriography (group II), and 11 had only duplex scans (group III). Ten group I, 15 group II, and 9 group III patients had an occluded aorta or iliac artery. Two patients (3 anastomosis) required placement of the distal anastomosis on the common femoral rather than the external iliac artery as planned preoperatively. Both had been arteriogrammed. No group III patient required deviation from the preoperative plan. Conclusion Aorto-iliac reconstruction can be performed without arteriography when a totally occluded aorta or iliac artery is identified by duplex scanning.