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Safety of saline irrigation for angioscopy: results of a prospective randomized trial.

Abstract：

:This study evaluates the hemodynamic effects and safety of saline irrigation necessary to obtain high-quality completion angioscopic studies, as compared with standard completion arteriography during infrainguinal bypass grafting. One-hundred ten patients undergoing primary infrainguinal bypass grafting, were prospectively randomized to either arteriography (N = 50) or angioscopy (N = 60) for a completion study to monitor the bypass procedure. All patients were hemodynamically monitored with pulmonary artery catheters and arterial lines. The arteriography group received an average of 27 ml (range 8-60 ml) of contrast per completion study, with a total administered intraoperative fluid volume of 2095 ml (range 650-4000 ml). The angioscopy group received an average bolus of 321 ml (range 90-650 ml) of irrigation fluid per completion angioscopy study, with a total administered intraoperative fluid volume of 2140 ml (range 850-5000 ml). Transient increases in pulmonary artery systolic and diastolic pressures and central venous pressures were measured during angioscopy. Although these changes reached statistical significance, the changes were of minimal clinical relevance, 1.9 (= 4.5), 1.6 (= 3.0) and 1.4 (= 2.3) mmHg respectively, and returned to baseline levels within 30 minutes. Intraoperative intervention with vasodilators and diuretics, the perioperative cardiac morbidity, and less than 30 day mortality, was not different between the two groups. Pressures generated within 24 bypass grafts were within physiologic arterial range for most of the study. With careful angioscopic technique applied and high quality care extended to the patient, irrigation with saline solution is simple, effective and safe.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Kwolek CJ,Miller A,Stonebridge PA,Lavin P,Lewis KP,Tannenbaum GA,Gibbons GW,Pomposelli FB Jr,Freeman DV,Campbell DR

doi

10.1007/BF02000670

subject

Has Abstract,Author List Incomplete

pub_date

1992-01-01 00:00:00

pages

62-8

issue

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)62242-5

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

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Safety of saline irrigation for angioscopy: results of a prospective randomized trial.