Color-flow duplex hemodynamic assessment of runoff in ischemic lower limb revascularization.
The objective of this study was to evaluate the existence of hemodynamic arterial flow correlation between preoperative duplex scanning (DS) and intraoperative direct outflow resistance (IDOR) measurements in ischemic lower limb revascularization. Sixty-eight ischemic lower limbs were submitted to preoperative DS. Anatomic and hemodynamic arterial characteristics of the outflow system were recorded, and the results were considered in the distal anastomosis placement site decision making. IDOR measurements were obtained at the same arterial segment, and Pearson's correlation coefficient test was performed to study the preoperative DS power in predicting the intraoperative outflow resistance. DS was technically satisfactory and helped define the distal anastomosis site in 93.2% of the cases (supragenicular popliteal artery, 19 [27.9%]; infragenicular popliteal artery, 10 [14.7%]; crural artery, 31 [57.4%]). A positive correlation could be found between preoperative DS and IDOR (0.450; p < .001). This correlation was particularly powerful in the crural artery (0.715; p < .001) when compared with the popliteal arterial segment (0.237; p = .192). Preoperative DS may help define the best distal arterial and outflow segment to be revascularized based on anatomic and hemodynamic parameters. There is a positive flow correlation between preoperative DS and IDOR that seems to be stronger in crural revascularization surgery.
Henrique Rossi
Fabio
F
Department of Vascular Surgery, Dante Pazzanese Cardiovascular Institute, São Paulo, Brazil. vascular369@hotmail.com
Puech-Leão
Pedro
P
Mitsuro Izukawa
Nilo
N
Pontes Junior
Sergio Cunha
SC
Massamitsu Kambara
Antonio
A
Mattos Barreto
Rodrigo Bellio
RB
Hassan Saleh
Mohamed
M
Gomes Ferreira Petisco
Ana Cláudia
AC
Vasconcelos Oliveira
Llanes Alberto
LA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003657:Decision Making; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance