Related Experiment Videos
Lower extremity revascularization without contrast arteriography: a prospective study of operation based upon duplex
P A Schneider1, D Y Ogawa, M P Rush
1Division of Vascular Surgery and Vascular Noninvasive Laboratory, Kaiser Medical Center, Honolulu 96819, HI, USA.
Cardiovascular Surgery (London, England)
|January 19, 2000
Summary
Duplex-guided lower extremity revascularization without arteriography is safe and effective in selected patients. This approach shows promising durability and avoids risks associated with contrast arteriography.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
Background:
- Preoperative contrast arteriography is standard for lower extremity surgical revascularization.
- Arteriography carries risks, including contrast-induced nephropathy and allergic reactions.
Purpose of the Study:
- To assess the safety and efficacy of lower extremity surgical revascularization guided solely by duplex arterial mapping in selected patients.
- To evaluate outcomes without routine preoperative contrast arteriography.
Main Methods:
- Prospective assessment of 24 selected patients undergoing revascularization based on duplex arterial mapping.
- Development and application of specific patient selection criteria.
- Accredited laboratory performance of aorto-iliac and infrainguinal duplex arterial mapping.
Main Results:
- Successful revascularization in patients with minor gangrene, rest pain, or claudication.
- Significant improvement in ankle-brachial index (0.49 to 0.80, P < 0.05).
- High primary patency (91.7%) and assisted primary patency (100%) at 18 months, with no graft occlusion or limb loss.
Conclusions:
- Duplex-guided lower extremity surgical revascularization without arteriography is a safe and durable option in carefully selected patients.
- Further refinement of patient selection criteria is necessary for broader implementation.