Duplex imaging of lower extremity bypasses, angioplasties, and stents

Duplex scan surveillance after lower extremity bypass and endovascular interventions can have a favorable impact on outcome. Its application during an arterial intervention to exclude technical or hemodynamic abnormalities and as part of a postoperative surveillance program to detect stenosis has been shown to improve patency. Results of duplex imaging can identify the arterial reconstruction at high risk of failure/thrombosis, which requires more intensive surveillance. Based on stenosis severity and anatomy, duplex scanning can suggest which repair technique (open surgery vs percutaneous balloon angioplasty [PTA]) is more appropriate. The use of duplex imaging during PTA of graft or peripheral artery stenoses (duplex-monitored balloon angioplasty) is recommended to verify normalization of velocity spectra, because this end point is associated with improved stenosis-free patency. A duplex surveillance program combined with correction of progressively stenotic lesions is recommended after lower limb bypass and PTA.