Related Experiment Videos
[Assessment of arterial occlusive disease with Duplex sonography. Prospective study]
L M Pedro1, J P Freire, A S Machado
1Instituto Vascular de Lisboa.
Insights
Color flow Duplex-Scan accurately detects renal artery occlusive disease, a cause of curable hypertension. This non-invasive method offers a reliable alternative to angiography for screening patients.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Nephrology
Background:
- Renal artery occlusive disease is a significant cause of curable hypertension and renal dysfunction.
- Conventional angiography is the primary diagnostic tool, but isotopic methods have shown limitations.
Purpose of the Study:
- To evaluate the efficacy of Color flow Duplex-Scan in diagnosing renal artery occlusive disease.
- To compare the non-invasive Duplex-Scan with digital subtraction arteriography.
Main Methods:
- A prospective, blind study involving 24 patients (48 renal arteries) was conducted.
- Color flow Duplex-Scan assessed the aorta and renal arteries, measuring velocity and visualizing flow.
- Digital subtraction arteriography served as the gold standard for comparison.
Main Results:
- The Duplex-Scan was adequate in 23 of 24 patients.
- It demonstrated high accuracy (93.5%), sensitivity (91.7%), and specificity (95.7%).
- False-positive and false-negative rates were low at 4.8% and 8.7%, respectively.
Conclusions:
- Color flow Duplex-Scan is a feasible and accurate non-invasive tool for assessing renal artery occlusive disease.
- It serves as a valuable screening method for hypertensive patients, potentially reducing the need for invasive procedures.
Abstract:
Occlusive disease involving the renal arteries represent a major cause of curable hypertension and improvement of renal dysfunction. Angiography is still the major diagnostic procedure. Isotopic methods with Captopril and split-function studies have shown high incidence of false-positive and false-negative results. Colour flow Duplex-Scan renders possible the visualization of the aorta and renal arteries, is noninvasive and combines morphologic and hemodynamic evaluation. To assess its efficacy in the diagnosis of renal artery occlusive disease, a prospective blind study was undertaken in 24 patients, 48 renal arteries, 15 women and 9 men, with mean age of 44 years. Scans of the aorta and renal arteries at the origin, along its extension and at the renal hilum were obtained using and ATL Ultrmark 9 with 3.0 MHZ probe Velocity measurements were obtained at the aorta and along the renal arteries. Criteria for a positive examination were: focal acceleration with a reduction of the flow velocity at the hilum. Absence of flow in a properly visualized renal artery was considered as occlusion. All patients had digital subtraction arteriography. In 1 patient the non-invasive examination was inadequate. In the remain 23 patients the exam was considered adequate. False-positives were 4.8%; false-negatives 8.7%. Sensitivity, specificity and accuracy were respectively 91.7%, and 95.7% and 93.5%. These results suggest that non-invasive assessment of renal artery occlusive disease is feasible and accurate when compared to angiography, thus providing a useful tool for screening hypertensive patients.