Can cruropedal colour duplex scanning and pulse generated run-off replace angiography in candidates for distal bypass surgery?

被引:27
作者
Koelemay, MJW [1 ]
Legemate, DA [1 ]
de Vos, H [1 ]
van Gurp, JA [1 ]
Reekers, JA [1 ]
Jacobs, MJHM [1 ]
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1100 DE Amsterdam, Netherlands
关键词
D O I
10.1016/S1078-5884(98)80086-5
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: To compare the diagnostic accuracy of duplex scanning (DS) and pulse generated run-off (PGR) with ia-DSA for the assessment of cruropedal outflow and explore the reliability of clinical decision making based on a work-up with DS/PGR in candidates for peripheral bypass surgery. Methods: Popliteal, crural and pedal arteries were evaluated independently with DS and in-DSA in 126 limbs of 120 consecutive patients for claudication (16%) or critical ischaemia (84%). Arterial segments were graded with DS and ia-DSA as normal, stenosed, or occluded and compared using weighted kappa (kappa) analysis. PGR tons used to select the best crural artery for bypass. Proposed management based on DS/PGR and, if applicable, anastomosis site were compared to definitive treatment based on ia-DSA. Results: Overall agreement between DS and ia-DSA for popliteal and crural arteries was moderate (kappa 0.51, 95% CI 0.48-0.55) with good agreement within the popliteal (kappa 0.67) and anterior tibial (kappa 0.61) arteries. Agreement was moderate within the pedal arterieds (kappa 0.32, 95% CI 0.24-0.40). In 74/126 (59%) limbs proposed management with DS/PGR was identical to in-DSA. In 23/29 (79%) femoropopliteal and 15/37 (41%) femorocrural bypasses DS/PGR agreed perfectly with ia-DSA with regard to acceptor artery and anastomosis site. Conclusion: DS can accurately assess the popliteal and anterior tibial arteries. In a substantial number of patients with severe lower limb ischaemia decisions for conservative management, PTA and femoropopliteal bypass can be based on a DS/PGR work-up.
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页码:13 / 18
页数:6
相关论文
共 25 条
[1]  
Altman DG., 1995, PRACTICAL STAT MED R
[2]   MULTICENTER TRIAL TO EVALUATE VASCULAR MAGNETIC-RESONANCE ANGIOGRAPHY OF THE LOWER-EXTREMITY [J].
BAUM, RA ;
RUTTER, CM ;
SUNSHINE, JH ;
BLEBEA, JS ;
BLEBEA, J ;
CARPENTER, JP ;
DICKEY, KW ;
QUINN, SF ;
GOMES, AS ;
GRIST, TM ;
MCNEIL, BJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (11) :875-880
[3]   PULSE-GENERATED RUNOFF - A NEW METHOD OF DETERMINING CALF VESSEL PATENCY [J].
BEARD, JD ;
SCOTT, DJA ;
EVANS, JM ;
SKIDMORE, R ;
HORROCKS, M .
BRITISH JOURNAL OF SURGERY, 1988, 75 (04) :361-363
[4]  
Caster JD, 1992, J VASCULAR TECHNOLOG, V16, P63
[5]   PULSE-GENERATED RUN-OFF VERSUS DEPENDENT DOPPLER ULTRASONOGRAPHY FOR ASSESSMENT OF CALF VESSEL PATENCY [J].
CURRIE, IC ;
WILSON, YG ;
DAVIES, AH ;
MICCICHE, M ;
WAKELEY, CJ ;
BAIRD, RN ;
LAMONT, PM .
BRITISH JOURNAL OF SURGERY, 1994, 81 (10) :1448-1450
[6]  
Davies A H, 1996, Cardiovasc Surg, V4, P161, DOI 10.1016/0967-2109(96)82307-6
[7]   DUPLEX ULTRASONOGRAPHY AND PULSE-GENERATED RUN-OFF IN SELECTING CLAUDICANTS FOR FEMOROPOPLITEAL ANGIOPLASTY [J].
DAVIES, AH ;
MAGEE, TR ;
PARRY, R ;
HAYWARD, J ;
MURPHY, P ;
COLE, SEA ;
BAIRD, RN ;
HORROCKS, M .
BRITISH JOURNAL OF SURGERY, 1992, 79 (09) :894-896
[8]  
Elsman BH, 1996, CARDIOVASC INTER RAD, V19, P313
[9]   IMPACT OF ULTRASONOGRAPHIC DUPLEX SCANNING ON THERAPEUTIC DECISION-MAKING IN LOWER-LIMB ARTERIAL-DISEASE [J].
ELSMAN, BHP ;
LEGEMATE, DA ;
VANDERHEIJDEN, FHWM ;
DEVOS, HJ ;
MALI, WPTM ;
EIKELBOOM, BC .
BRITISH JOURNAL OF SURGERY, 1995, 82 (05) :630-633
[10]   COLOR DOPPLER IMAGING OF INFRAINGUINAL ARTERIAL OCCLUSIVE DISEASE [J].
HATSUKAMI, TS ;
PRIMOZICH, JF ;
ZIERLER, RE ;
HARLEY, JD ;
STRANDNESS, DE .
JOURNAL OF VASCULAR SURGERY, 1992, 16 (04) :527-533