2006, Number 3
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Rev Mex Angiol 2006; 34 (3)
Early results in infrainguinal revascularization based on color Doppler duplex scanning
Nuricumbo VA, Serrano LJA, Cossío ZA, Sánchez NNE, Cal y Mayor TI, García GJE, Huerta HH, Rodríguez AE, Romero JC
Language: Spanish
References: 29
Page: 98-102
PDF size: 50.60 Kb.
ABSTRACT
Objectives: Describe the early results in infrainguinal revascularization surgery based on duplex scannning, in the Department of Angiology and Vascular Surgery of “Lic. Adolfo López Mateos” hospital from ISSSTE.
Patients and methods: In this study, twenty-one patients were included. Before surgery patients were screened by interrogation, physical exploration, and a Doppler duplex scanning of the affected limb. All the studies determined ultrasonographic and spectral characteristics. During surgery an angiography was performed to determine the viability of tibial vessels and plantar arch.
Results: Twenty one patients were operated on different indications critical limb ischaemia en 18 patients (85.71%) and claudication in 3 cases (14.28%). The limb salvage rate was 85.7% and only three patients were amputated. We had one fatality from postoperative myocardial infarction.
Conclusions: Because this is a descriptive study with a limited number of patients it is hard to give an objective vision. Nevertheless the numbers obtained in this study an others reported earlier, the rate of limb salvage for revascularization based solely on duplex scanning is very similar to the limb salvage rate of the surgery planned with conventional angiography, and it is a viable possibility for screening the patients before the surgery without the use of angiography, because it is a diagnostic method associated to patient discomfort, potential of nefrotoxicity, exposure to radiation, an costs of the study and hospitalization. Preoperative duplex screening is a relatively new modality for the study of vascular disease. Thus, this could indicate that in the future, the preoperative duplex screening could substitute the preoperative angiography.
REFERENCES
Rutherford RB. Vascular Surgery. 5a. Ed. Vol. 1. Ed. Saunders Company; p. 313-49, 917-1018.
Calvin BE. Current therapy in vascular surgery. 4a. Ed. Ed. Mosby; p. 447-557.
Ernest Zwibel. Ultrasonografia Doppler. 3a. Ed. Ed. Marban; p. 23-47, 185-233.
Allard L, Clouthier G, Durand LG, Roederer GO, Langlois YE. Limitations of ultrasonic duplex scanning for diagnosing lower limb arterial estenoses in the presence of adjacent segment disease. J Vasc Surgery 1994; 19: 650-7.
Koelemay MJ, Den Hartog D, Prins MH, Kromhout JG, Legemate DA, Jacobs MJM. Diagnosis of arterial disease of the lower extremities with duplex ultrasonography. Br J Surgery 1996; 83: 404-9.
Koelemay MJ, Den Hartog D, Prins MH, Kromhout JG, Legemate DA, Henk de Vos A, Ron Balm MD, Reekers MD, Jacobs M. Duplex scanning allows selective use of arteriography in the management of patients with severe lower leg arterial disease J Vasc Surgery 2001: 34 : 661-7.
Koelemay MJ, Legemate DA, van Gurp J, Ponson EA, Reekers JA, Jacobs MJ. Colour duplex scanning and pulse generated run-off for assessment of popliteal and cruropedal arteries before peripheral bypass surgery. Br J Surgery 1997; 84: 1115-9.
Wain RA, Berdejo GL, DelValle WN, Lyon RT, Sanchez LA, Suggs WD. Can duplex scan arterial mapping replace contrast arteriography as the test of choice before infrainguinal revascularization? J Vasc Surgery 1999; 29: 100-7.
Elsman BH, Legemate DA, Vander Heijden FH, de Vos HJ, Mali WP, Eikelboom BC. Impact of ultrasonografic duplex scanning on therapeutic decision making in lower-limb arterial disease. Br J Surgery 1995; 82 : 630-3.
Cossman DV, Ellison JE, Wagner WH, Carroll RM, Treiman RL, Foran RF. Comparison of contrast arteriography to arterial mapping with color-flow duplex imaging in the lower extremities. J Vasc Surgery 1989; 10: 522-8.
Polak JF, Karmel MI, Mannick JA, O’Leary DH, Donaldson MC, Whittemore AD. Determination of the extent of lower-extremity peripheral arterial disease with color-assisted duplex sonography: comparison with angiography. AJR Am J Roetgenol 1990; 155: 1085-9.
Ligush J Jr, Reavis SW, Preisser JS, Hansen KJ. Duplex ultrasound scanning defines operative strategies for patients with limb-threatening ischaemia. J Vasc Surgery 1998; 28: 482-90.
Mazzariol F, Ascher E, Hingorani A, Gunduz Y, Yorkovich W, Salles-Cunha S. Lower extremity revascularization without preoperative contrast arteriography in 185 cases: lessons learned with doppler ultrasound arterial mapping. Eur J Vasc Endovasc Surgery 2000; 19: 509-15.
McCarthy MJ, Nidal S, Hartshorne T, Naylor AR, Bell PR, London NJ. Coulor coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels. Br J Surgery 1999; 86: 33-7.
Proia RR, Walsh DB, Nelson PR, Connors JP, Powel RJ, Zwolak RM, Fillinger MF, Cronenwett JL. Early results of infragenicular revascularization based solely on duplex arteriography.
Leiner T, Tordoir JH, Kessels AG, Neelmans MD, Schurink MD, Kitslaar PJ, Engelshoven MA. Comparison of treatment plans for peripheral arterial disease made with milti-station contrast medium-enhanced magnetic resonance angiography and duplex ultrasound scanning. J Vasc Surgery 2003; 37: 1255-62.
Asher E, Mazzariol F, Hingorani A, Salles-Cunha S, Gade P. The use of duplex ultrasound arterial mapping as an alternative to conventional arteriography for primary and secondary infrapopliteal bypasses. Am J Surgery 1999; 178: 162-5.
Sansier Y, Fishwick G, Owen R, Pemberton M, Bell PR, London NJ. A comparison between colour duplex ultrasonography and arteriography for imaging of infrapopliteal lesions. Eur J Vasc Endovascular Surgery 1998; 15: 44-50.
Larch E, Minar E, Ahmadi R, Schnurer G, Schneider B, Stumpflen A. Value of color duplex sonography for evaluation of tibioperoneal arteries in patients with femoropopliteal obstruction: a prospective comparison with anterograde intrarterial digital substraction angiography. J Vasc Surgery 1997; 25: 629-36.
Rzucidlo EM, Walsh DB, Powell RJ, Zwolak RD, Fillinger MF, Schermerhorn ML, Cronenwett JL. Prediction of early graft failure with intraoperative completion duplex ultrasound scan. J Vasc Surgery 2002; 36: 975-81.
Ramaswami G, Al-Kotoubi A, Nicolaides AN, Dhajanjil S, Coen LD, Belcaro G. The role of duplex scanning in decisión making for patients with claudication. Ann Vasc Surgery 1999; 13: 606-12.
Huber TS, Back MR, Flynn TC, Harward TR, Culp WC, Carlton LM. Intraoperative prebypass arteriography for infrageniculate revascularization. Am J Surgery 1997; 174: 205-9.
Sansier Y, Hartshorne T, Thrush A, Nydahl S, Bolia A, London NJ. A prospective comparison of lower limb colour coded duplex scanning with arteriography. Eur Jour Vasc Endovasc Surgery 1996; 11: 170-5.
Moneta GL, Yeager RA, Antonovic R, Hall LD, Caster JD, Cummings CA. Accuracy of lower extremity arterial duplex mapping. J Vasc Surgery 1992; 15: 275-83.
Wilson YG, George JK, Wilkins DC, Ashley S. Duplex ultrasound assessment of run-off before femorocrural reconstruction. Br J Surgery 1997; 84: 1360-3.
Karacagil S, Lofberg AM, Ganbo A, Lorelius LE, Bergqvist D. Value of duplex scanning in evaluation of crural and foot arteries in limbs with severe lower limb ischaemia- a prospective comparison with angiography. Eur J Vasc Endovascular Surgery 1996; 12: 300-3.
Egglin TK. O’Moore PV, Feinstein AR, Waltman AC. Complications of peripheral angiography: a new system to identify patients at high risk. J Vasc Surgery 1995; 22: 787-94.
Pemberton M, London NJ, Colour flow duplex imaging of occlusive arterial disease of the lower limb. Br J Surgery 1997; 84: 912-19.
Lai DT, Huber D, Glasson R, Grayndler V, Evans J, Hogg J. Colour duplex ultrasonography versus angiography in the diagnosis of lower extremity arterial disease. Cardiovasc Surgery 1996; 4: 384-8.
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