Angioscopic evaluation of unilateral aortic graft limb thrombectomy: is it helpful?

Objective: Graft thrombectomy is often an effective method for restoring inflow in an occluded limb of an aortobifemoral graft. A major determinant for its success is the completeness of thrombus removal from the graft, verification of which can be performed by angioscopy.

Methods: A retrospective review since January 1989 identified 51 unilateral graft limb thrombectomy operations in 35 patients. At the discretion of the surgeon 20 of these procedures included angioscopic inspection of the graft for significant retained thrombus, which was found and retrieved in 11 (55%).

Results: Visualization of the graft limb was very good, but inspection of the graft body was not possible. There were no angioscopy-related complications. Within the first 4 months after graft limb thrombectomy and reconstruction, four of 20 patients in the group inspected by angioscopy and nine of 31 in the conventionally treated group had reocclusion of the treated limb.

Conclusions: These results suggest that angioscopy can be a helpful adjunct in the successful inflow management of aortic graft limb thrombectomy to verify the completeness of clot removal.