Combined surgical and radiological procedures

Background: The aim was to audit the effect of provision of an interventional theatre on the management of vascular disease in a tertiary centre. Methods: All patients undergoing joint vascular surgical and radiological procedures during 20 months were reviewed. Data are presented with respect to type of procedure, initial success and length of hospital stay. Results: Between October 1997 and July 1999, 100 combined procedures were performed in an endovascular operating theatre. Sixty of these were for stent‐graft repair of abdominal aortic aneurysm and are excluded from further analysis. Forty patients (23 men and 17 women, of median age 65 (range 37–80) years) underwent combined procedures for claudication (nine), rest pain (13), tissue necrosis (five), acute ischaemia (seven), iliac aneurysm (three), amaurosis fugax (one), arteriovenous malformation (one) and subclavian vein occlusion (one).Radiological procedures n Surgical procedures nAngioplasty 16 Arterial exposure only 14 Stent 18 Infrainguinal bypass 10 Embolectomy 3 Thrombendarterectomy 9 Coil embolization 4 Patch angioplasty 2 Arteriography 1 Amputation/debridement 2 Covered stent 4 No surgery performed 3Combined intervention was successful initially in 35 patients. Of the five failures, three were technical (not possible to cross an occluded vessel) and two were due to absence of run‐off vessels. There was no perioperative death. Median hospital stay was 9 (range 1–116) days. Conclusion: These data confirm that patients requiring both radiological and surgical intervention can be treated successfully within the confines of an interventional operating suite. Cooperation and coordination between surgeon and radiologist allows the tailoring of procedures to the individual patient's needs. © 2000 British Journal of Surgery Society Ltd