Therapeutic consequences of variation in intraarterial pressure measurements after iliac angioplasty.
OBJECTIVE
To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty.


METHODS
In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD +/- SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg.


RESULTS
MD +/- SD for repeated measurements at rest and during flow augmentation were 0 +/- 2 mmHg and 1 +/- 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 +/- 7 mmHg at rest and 17 +/- 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions.


CONCLUSIONS
Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.
Tetteroo
E
E
Department of Radiology, Room E.01.132, University Hospital Utrecht, Heidelberglaan 100, NL-3584 CX Utrecht, The Netherlands.
Haaring
C
C
van Engelen
A D
AD
van der Graaf
Y
Y
Mali
W P
WP
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012680:Sensitivity and Specificity; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology