Laser Doppler Blood Flow Monitoring in Reconstructive Vascular Surgery: Case Studies

Abstract

Laser Doppler flowmetric (LDF) measurements were performed preopera tively and postoperatively in patients undergoing arterial reconstruction in the lower limb, and intraoperatively in patients undergoing abdominal aortic re construction.

In 21 instances of successful arterial reconstruction in the lower limb, post operative LDF values from the skin of the foot were significantly higher than those obtained preoperatively. In 4 instances, depressed LDF values immedi ately after surgery clearly heralded thrombotic complications.

In 5 patients operated upon for occlusive disease of the aorta, LDF values from the skin of one foot were significantly higher at the end of surgery than those obtained when surgery was started. In 2 cases of aneurysm, LDF values decreased but distal pulses were normal. In 2 of these 7 patients, intraoperative embolization was instantly detected. In 1 case of severe microembolization from an aortic aneurysm, a low and unchanged LDF value was recorded throughout the reconstructive procedure, indicating thrombosis of the microvasculature.

These observations indicate that laser Doppler flowmetry is useful in recon structive vascular surgery to determine the patency of reconstructed vessels and also to detect thromboembolic complications during and after operation.

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