Pulsed Doppler angiography in lower limb arterial ischemia

A 30-channel pulsed Doppler vessel imaging system (MAVIS, GEC Medical, Middlesex, England), was used to obtain images and maximal Doppler velocity time waveforms in the diagnosis of stenosis of the origin of the profunda femoris artery (PFA) and in the detection of structural changes within Dacron arterial grafts. In PFA scans of 33 limbs in 22 patients (mean age, 52 years), PFA stenosis of more than 50% at operation was invariably associated with a damping factor of the maximal Doppler velocity-time waveform of greater than 1.5 (eight limbs). In 12 limbs with a normal PFA at operation, the damping factor was always less than 1.4, and in 13 limbs of normal patients without arterial disease, the damping factor was always less than 1.34. In studies of 10 mm arterial grafts, the internal diameter of 14 iliopopliteal grafts scanned just above the popliteal anastomosis was strikingly reduced as compared with the femoral anastomosis of 14 aortoiliofemoral grafts and seven axillobifemoral grafts. These preliminary results suggest that MAVIS studies can be used noninvasively to detect PFA stenosis and to identify luminal narrowing of iliopopliteal grafts.