Infrainguinal endovascular procedures based upon the results of duplex scanning.
OBJECTIVE
The aim of this study was to report the role of duplex scanning in selection of patients with lower limb ischemia for infrainguinal endovascular revascularization.


METHODS
From January 2002 to December 2005, 95 patients (66 male, 29 female) underwent infrainguinal endovascular revascularization based on duplex scanning. The indications for surgery were severe claudication (11%), rest pain (15%), gangrene (40%), and non-healing ulcer (34%).


RESULTS
Duplex procedure time averaged 60+/-30 min. A total of 120 arterial hemodynamic relevant lesions were treated with endovascular therapy, 47 were localized in the aorto-iliac segment, 55 in the femoro-popliteal segment and 18 were infrapopliteal. Out of a total of 120 lesions, 107 (89%) were successfully dilated; 105 lesions (88%) predicted by preoperative duplex scanning were confirmed by contrast arteriography (CA) at the time of surgery. Additional lesions were revealed by intraoperative arteriography in 15 cases (12%). The accuracy and sensitivity of duplex scanning in the selection of aorto-iliac lesions for endovascular procedures was 86%, 91% for femoro-popliteal lesions, and 78% for infrapopliteal lesions.


CONCLUSIONS
The results of this experience show that duplex scanning may be a safe alternative to CA for patients with chronic limb ischemia. Adequate training and experience is necessary to utilize this technique for the selection of patients for infrainguinal endovascular procedures.
Canciglia
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School of Vascular Surgery, University of Messina, Messina, Italy. aldocanciglia@libero.it
Mandolfino
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D016638:Critical Illness; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011150:Popliteal Artery / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex