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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2007, Number 3

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Rev Mex Angiol 2007; 35 (3)

Pursuit with ultrasound Doppler in revascularization of pelvic extremities, experience of three years

Ramírez SO

Language: Spanish
References: 16
Page: 102-107
PDF size: 245.47 Kb.


ABSTRACT

Objective: Report our experience with color Doppler ultrasound surveillance for limb by pass surgery within a 3-year period.
Patients and methods: From June 2003 to January 2007 we review 27 patients with a mean age of 67.7 years, seventeen patients (63%) were female and ten (37%) were male. Six months follow up was 100% and at thirty six months 11%. We determined standard values for arterial diameter and peak systolic velocity (PSV) in healthy subjects. Twenty two patients (77.7%) had Diabetes mellitus and twenty five (92.5%) had critical limb ischemia as co-morbid diseases. We studied 27 by pass procedures, twenty five (95%) reversed saphenous vein (RSV) graft (95%) and two PTFE prosthetic material (7.4%). We perform eco Doppler follow up to value subcutaneous tissue, graft anatomy, luminal diameter, anastomotic sites, native run- off vessels diameter, graft and anastomotic flow velocities.
Results: We found .3 to .6 mm RSV diameters, at paramaleolar out flow vessels diameters was from .23 to .5 mm, graft peak flow velocities from 5.6 to 55.2 cm/s. The criterion for identifying a graft risk was monophasic velocity radio more than two, changes in spectral waves with PSV lower than 20 cm/s, combined with physical examination and intraluminal defects. We documented lesions with eco Doppler in eight patients (29.6 %) with 96% limb salvage.
Conclusions: The eco Doppler is useful to monitoring the functional of infrainguinal by pass surgery. Based on elective surgery and limb salvage versus emergence intervention and amputation, the eco Doppler follow up is cost-effective. In our study the PSV were lower probably because a high percentage of the patients has one vessel run off and the severity of ischemia.


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