Assessment of the hemodynamic result of PTA with a Doppler guide wire: Initial experience

PURPOSE: To determine the usefulness of a Doppler guide wire for assessing the hemodynamic results of balloon dilation of atherosclerotic arterial obstruction. MATERIALS AND METHODS: A 0.018-inch 12-MHz Doppler guide wire was used to measure the maximum peak velocity and the time-averaged peak velocity (APV) proximal to, inside, and distal to lesions in 10 consecutively seen patients (six men, four women; mean age, 68 years +/- 11 [standard deviation]). Measurements were made before and after percutaneous transluminal angioplasty (PTA). RESULTS: The proximal-to-intrastenotic APV ratio was the best predictor of the grade of residual stenosis and correlated well with angiographic measurements (r = .8). Balloon dilation resulted in a significant increase in mean APV distal to the obstruction (12.5 cm/sec before versus 27.6 cm/sec after PTA; P < .05). The mean proximal-to-distal APV ratio also decreased significantly (3.7 before versus 1.0 after PTA; P < .005). CONCLUSION: The Doppler guide wire can be used for direct intravascular evaluation of the result of balloon dilation in atherosclerotic obstructions.