Vascular Surgery

What are you using for completion control currently?

The practical recommendation is that TTFM competion control can and should be utilized at the end of virtually every open or hybrid vascular surgical operation.

- Vikatmaa & Albäck, 2018

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Peripheral Bypass

Critical limb-threatening ischemia (CLTI) is the most advanced stage of peripheral artery disease and greatly increases the risk of limb loss. Medistim provides an intraoperative quality assessment system that combines flow measurement and imaging to give immediate feedback on graft patency and enable revision before closure. Volumetric flow values are key for predicting graft longevity, and low flow or lack of response to a vasodilator stress test indicates higher risk of early occlusion. Medistim’s imaging probe can reveal hidden anastomotic imperfections, allowing surgeons to correct issues during surgery. Because graft patency strongly predicts long-term outcomes, this technology helps improve patient survival and limb salvage.

Carotid Endarterectomy (CEA)

Medistim combines Transit Time Flow Measurement (TTFM) with high-frequency ultrasound imaging to help reduce the risk of perioperative stroke during CEA. Ultrasound provides immediate visualization of the carotid lumen, revealing imperfections that might otherwise be missed and allowing revision before closure. The CIDAC study shows that intraoperative duplex ultrasound (IDUS) detects more high-grade defects than angiography and has higher inter-observer reliability. The 2023 ESVS Guidelines recommend intraoperative monitoring and quality control after CEA—supported by a 2021 meta-analysis and the CIDAC findings—showing that both ultrasound imaging and angiography lower the risk of death and stroke.

AV Access Surgery

In AV access, a fistula that fails to mature due to low flow can lead to reintervention and prolonged catheter use, offering no lasting solution for the patient. Studies show that volumetric flow rates predict vascular access outcomes, and using TTFM with intraoperative imaging allows immediate correction to support long-term fistula function and reduce reinterventions. Conversely, excessively high flow increases the risk of hand ischemia and heart failure, but intraoperative flow-guided reduction is an effective and durable treatment. The MiraQ device supports successful fistula maturation and reliable high-flow modulation, improving long-term shunt performance and patient quality of life.

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Vascular Surgery

Peripheral Bypass

Carotid Endarterectomy (CEA)

AV Access Surgery

Discover MiraQ firsthand — request a demo today and witness the integration of precision and insight in action.

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