The role of duplex scanning versus angiography in predicting outcome after balloon angioplasty in the femoropopliteal artery. J Vasc Surg 1992 May;15(5):860-5; discussion 865-6
Date
05/01/1992Pubmed ID
1533685Scopus ID
2-s2.0-0026721844 (requires institutional sign-in at Scopus site) 73 CitationsAbstract
Duplex-derived velocity measurements were used to assess the hemodynamics of 64 femoropopliteal arterial sites in 59 patients after angiographically successful percutaneous transluminal balloon angioplasty. With use of angiography as the gold standard, percutaneous transluminal balloon angioplasty was judged to be successful if (1) evidence existed of a "split" caused by intimal dissection and splitting of atherosclerotic plaque; and (2) no significant diameter-reducing residual stenosis was observed at the percutaneous transluminal balloon angioplasty site. At 1 month, 55 limbs (86%) were hemodynamically and clinically improved by SVS/ISCVS clinical criteria for chronic limb ischemia. Of the 55 percutaneous transluminal balloon angioplasty sites, duplex scanning had identified 40 (63%) sites with a less than 50% diameter-reducing stenosis and 15 (27%) sites with a greater than 50% diameter-reducing stenosis within a week after percutaneous transluminal balloon angioplasty. Independent review of the 55 angiograms taken after percutaneous transluminal balloon angioplasty identified 39 sites (71%) with a split and 16 sites (29%) without. By life-table analysis, a greater than 50% diameter-reducing stenosis predicted a worse clinical outcome (15% at 1 year) compared with the presence of a less than 50% diameter-reducing stenosis (84% at 1 year) (p less than 0.001; log rank test). The presence or absence of an angiographic split was not a predictive factor of percutaneous transluminal balloon angioplasty outcome (split, 61% at 1 year; no split, 62% at 1 year) (p = 0.832; log rank test). The detection of a functional residual stenosis by duplex scanning did not correlate with angiographic appearance, but was predictive of clinical failure.(ABSTRACT TRUNCATED AT 250 WORDS)
Author List
Mewissen MW, Kinney EV, Bandyk DF, Reifsnyder T, Seabrook GR, Lipchik EO, Towne JBMESH terms used to index this publication - Major topics in bold
AdultAged
Aged, 80 and over
Angioplasty, Balloon
Arterial Occlusive Diseases
Blood Flow Velocity
Female
Femoral Artery
Humans
Life Tables
Male
Middle Aged
Popliteal Artery
Predictive Value of Tests
Prospective Studies
Radiography
Treatment Outcome
Ultrasonography