Selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty with duplex scanning.
OBJECTIVE
To evaluate the role of duplex scanning in the selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty (PTA).


METHODS
From January 1995 through May 2000, 702 patients (952 limbs), with chronic lower extremity ischemia due to infrainguinal atherosclerotic disease diagnosed by duplex scanning, were retrospectively studied. Diagnostic angiography (130 limbs) or infrainguinal PTA (108 limbs) was performed in 238 limbs. Two investigators retrospectively analyzed the duplex examinations and angiographies in a blinded manner and used similar criteria for the interpretation of lesions suitable or not suitable for PTA.


RESULTS
The superficial femoral, popliteal and crural artery lesions were correctly selected for PTA in 85%, 66% and 32%, respectively. The accuracy, sensitivity, specificity, negative predictive value and positive predictive value of duplex scanning to appropriately categorize femoropopliteal lesions as suitable or unsuitable for PTA were 89%, 83%, 92%, 94% and 78%, respectively. The accuracy of duplex scanning for predicting the performance of infrainguinal PTA was 83%.


CONCLUSIONS
Duplex scanning has an important impact on the selection of treatment modalities in limbs with infrainguinal arterial occlusive disease. Femoropopliteal lesions can be reliably selected to PTA according to duplex scan findings.
Boström Ardin
A
A
Department of Surgery, University Hospital, Uppsala, Sweden.
Löfberg
A-M
AM
Hellberg
A
A
Andrén
B
B
Ljungman
C
C
Logason
K
K
Karacagil
S
S
D000368:Aged; D000800:Angioplasty, Balloon; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018616:Ultrasonography, Doppler, Duplex