title: The value of duplex surveillance after endovascular intervention for femoropopliteal obstructive disease.
abstract: OBJECTIVE
  The objective of the present study was to assess prospectively whether serial Duplex examination was useful in identifying impending failure after endovascular interventions of the femoropopliteal arteries.
  
  
  METHODS
  Non-university hospital. Prospective clinical study.
  
  
  METHODS
  124 Patients were successfully treated by endovascular procedures during a 5 year period. The follow-up was by colour-flow Duplex examination at fixed intervals. At similar intervals clinical examination, including ankle blood pressure measurement was performed to assess the clinical/haemodynamic status of the patients according to the SVS/NAISCVS guidelines. For the diagnosis of impending failure the Duplex criterion was a peak systolic velocity ratio > 2.5 and the clinical/haemodynamic criterion was a level < +2. Actual failure of the vascular procedure was defined as the occurrence of an occlusion in the treated arterial segment or a recurrent stenosis causing symptoms severe enough to require a reintervention. No prophylactic reinterventions were performed on the basis of abnormal Duplex findings alone.
  
  
  RESULTS
  Abnormal Duplex findings indicating restenosis were observed in 52 patients. Duplex abnormalities predicted treatment failure with a sensitivity of 86% and a specificity of 75%, while clinical/haemodynamic assessment had a sensitivity of 93% and a specificity of 90%. The hypothetical management outcome if Duplex surveillance had been used as a basis for reintervention was assessed. It appeared that only one patient with failure would have received a redo endovascular procedure at the time he had a restenosis.
  
  
  CONCLUSIONS
  Clinical/haemodynamic assessment was more useful for the follow-up of endovascular interventions than Duplex surveillance.
authors: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors: A V
authors: AV
authors: Tielbeek
authors: E
authors: E
authors: Rietjens
authors: J
authors: J
authors: Buth
authors: D
authors: D
authors: Vroegindeweij
authors: F P
authors: FP
authors: Schol
mesh_terms: D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D017073:Atherectomy; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012680:Sensitivity and Specificity; D013997:Time Factors; D017211:Treatment Failure; D018616:Ultrasonography, Doppler, Duplex