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23 patients with obstruction of one or both main iliac arteries underwent one or more transluminal angioplasties by catheterization via the obstructed vessel. 26 iliac arteries were thus reopened. The length of obstructions varied from 1 to 10 cm. The majority of the obstructions were of recent onset whilst in 6 cases the presumed date was more than 6 months previously. In all cases potency was obtained with normal follow-up angiograms in 20 cases, and a residual though not hemodynamically significant stenosis in 6 cases. All patients were followed up by Doppler and in the majority of cases by venous digital angiography, with a follow-up at the present time of 6 months to 2 years. 2 patients underwent surgery because of reobstruction occurring 2 and 13 months after dilatation. Cumulative patency is 79% in 2 years, similar to results obtained by surgery. These results show that iliac angioplasty, a simple procedure, may avoid or delay surgery, and that it should be widely used in this precise anatomical indication.

Post-operative thrombosis in vascular surgery results from either technical error of deficient arterial outflow and can be avoided by checking, during the operation, that the new circulatory conditions created are adequate. Among the most frequently used control methods arteriography occupies a prominent place but requires a sophisticated equipment to be truly reliable. Per-operative measurement of the blood flow is much simpler. It objectively assesses the haemodynamic value of the arterial reconstruction and provides useful information on the short-and medium-term patency of the vessels.

This study attempts to measure inter-observer variability in reading 14 carotid angiograms and 8 aortograms. 24 surgeons and radiographs with training in arterial diseases participated in the study from different hospitals. The results were analysed with the Kappa statistical method which incorporate a correction for the extend of agreement expected by chance alone, in the evaluation of the reliability of diagnostic procedures. From a topographic point of view, the interpretation of the proximal arterial segments is more reliable than the distal segments, with the exception of the aorto-iliac bifurcation and the profunda femoral arteries. Inter-observer agreement is the most important for the occlusive lesions and the identification of stenosis is of poor reliability.

Thirty patients were examined by 4 procedures, conventional angiography (C.A.), peripheric intravenous digital subtraction angiography (D.S.A.), ultrasonography and Doppler on femoral artery bifurcation. These arteries are divided into several sections on which findings were classified into three or five categories. There is an excellent correlation between conventional and digital angiograms. Various results of D.S.A. versus C.A. were obtained in 2% of these sections. More differences were noticed between C.A. and Doppler (7%), C.A. and ultrasonography (10%). There is a positive correlation of D.S.A. versus C.A. With Doppler and ultrasonography, arterial map is difficult to establish especially in case of many stenoses of the iliac arteries or thrombosis on femoral superficialis arteries.