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Conventional angiography is considered by
many to be the most accurate method of obtaining anatomic and pathologic
information about the vascular anatomy and is the reference standard
imaging technique prior to microsurgical reconstruction. 1-4
Angiography is performed through arterial puncture typically of the
femoral artery. Contrast dye is then injected and images are obtained of
the desired anatomic region. Angiography is quite effective in determining
arterial abnormalities such as stenosis, spasm, intimal injury and
occlusion. Images can be obtained in multiple planes in order to best
define the area of interest.
Angiography has been widely used for
evaluation of potential recipient sites, particularly the lower extremity
following trauma. In addition, angiography has been commonly used for
imaging the lower extremity prior to fibula harvest. Failure to identify
congenital abnormalities such as the absence of a peroneal artery and
peroneal arterial magna, where the peroneal artery is the main blood
supply to foot could result in devastating complications from fibula
harvest. 3 Angiography can also reliably identify acquired
vascular disorders such as arteriosclerosis which can impact selection of
donor and recipient vessels.
There are several potential complications
associated with angiography, including arterial occlusion, pseudoaneurysm,
renal failure and hematoma. 5-7 Overall, the complication rate
in the literature ranges from three to five percent.8 In
addition, traditional angiography requires the presence of a physician
throughout the procedure, a lengthy post-procedure recovery as well as a
high cost when compared with other imaging modalities.
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