Duplex imaging of lower extremity bypasses, angioplasties, and stents.
Duplex scan surveillance after lower extremity bypass and endovascular interventions can have a favorable impact on outcome. Its application during an arterial intervention to exclude technical or hemodynamic abnormalities and as part of a postoperative surveillance program to detect stenosis has been shown to improve patency. Results of duplex imaging can identify the arterial reconstruction at high risk of failure/thrombosis, which requires more intensive surveillance. Based on stenosis severity and anatomy, duplex scanning can suggest which repair technique (open surgery vs percutaneous balloon angioplasty [PTA]) is more appropriate. The use of duplex imaging during PTA of graft or peripheral artery stenoses (duplex-monitored balloon angioplasty) is recommended to verify normalization of velocity spectra, because this end point is associated with improved stenosis-free patency. A duplex surveillance program combined with correction of progressively stenotic lesions is recommended after lower limb bypass and PTA.
Roth
S M
SM
Division of Vascular Surgery, University of South Florida College of Medicine, Tampa, USA.
Bandyk
D F
DF
D000465:Algorithms; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery*; D011182:Postoperative Care; D015607:Stents; D013997:Time Factors; D018616:Ultrasonography, Doppler, Duplex