Duplex scanning or arteriography for preoperative planning of lower limb revascularisation.
OBJECTIVE
to compare the accuracy of duplex and angiography for the planning of lower limb revascularisation.


METHODS
Sixty limbs (82% with critical limb ischaemia) were assessed by means of duplex by one surgeon and by angiography by another in terms of the optimum inflow and outflow sites for arterial bypass. These data were then compared with the final operation performed which was used as the gold standard. Surgeons were blinded to the determinations of the other.


RESULTS
surgical plans based on duplex scan and angiography were correct in 77% (40/52) and 79% (41/52), respectively and plans based on the one imaging modality was modified by the other in only 1 and 2 instances. The diagnostic agreement between duplex scanning and arteriography was excellent (Kappa value=0.94, 95% C.I. 0.89-0.98).


CONCLUSIONS
the reliability of duplex scanning is comparable to digital angiography in the preoperative planning of lower extremity arterial reconstruction. However neither exam can be considered as the gold standard because intraoperative arteriography needs to be available in a significant number of infrapopliteal procedures.
Vascular Surgery Unit, Fundación Hospital Alcorcón, Madrid, Spain.
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Luján
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Criado
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Puras
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Izquierdo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D011300:Preoperative Care; D011446:Prospective Studies; D016037:Single-Blind Method; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*; D014656:Vascular Surgical Procedures