Duplex assessment of run-off before femorocrural reconstruction.
BACKGROUND
This study was a prospective evaluation of colour duplex imaging for the assessment of distal run-off before femorocrural reconstruction.


METHODS
Patients with critical ischaemia who required a distal bypass underwent preoperative run-off assessments using dependent Doppler, arteriography and duplex imaging by a vascular surgeon, radiologist and technologist respectively; each was blinded to the findings of the others. Preoperative data were compared with intraoperative clinical findings and completion flow studies/ arteriograms.


RESULTS
Forty-three consecutive patients (33 men, ten women; mean age 78 (range 53-95) years; 12 diabetic) undergoing 44 femorocrural reconstructions for critical ischaemia were assessed. The 30-day primary cumulative graft patency for the series was 86 per cent. Dependent Doppler correctly predicted a suitable run-off vessel in 21 limbs but was indeterminate in four and unrecordable in 19. Arteriography correctly predicted a suitable run-off vessel in 32 cases, but was indeterminate in six and failed to demonstrate run-off in three patients. Arteriography suggested an inferior vessel in three cases. Duplex correctly predicted a suitable run-off vessel for all 44 grafts.


CONCLUSIONS
Duplex imaging is superior to arteriography for preoperative assessment of distal run-off for femorocrural reconstruction.
Wilson
Y G
YG
Vascular Surgical Unit, Derriford Hospital, Plymouth, UK.
George
J K
JK
Wilkins
D C
DC
Ashley
S
S
D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation; D003657:Decision Making; D005260:Female; D005268:Femoral Vein; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016909:Tibial Arteries; D018615:Ultrasonography, Doppler, Color / Q000592:standards; D018084:Ultrasonography, Interventional; D014654:Vascular Patency