This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Bostrdm, A. Articles by Hellberg, A. Search for Related Content PubMed Articles by Bostrdm, A. Articles by Hellberg, A. Social Bookmarking                         What's this?

Selection of Patients with Lower Limb Arterial Occlusive Disease for Endovascular Treatment of the Iliac Arteries with Duplex Scanning

Sadettin Karacagil, MD, PhD

Department of Surgery, University Hospital, Uppsala, Sweden

Ann-Marie Löfberg, MD

Christer Ljungman, MD, PhD

Rickard Nyman, MD, PhD

Department of Radiology, University Hospital, Uppsala, Sweden

Karl Logason, MD, PhD

Anders Hellberg, MD, PhD

Department of Surgery, University Hospital, Uppsala, Sweden

The aim of this study was to evaluate the role of duplex scanning in selection of patients with lower limb arterial occlusive disease for endovascular treatment of the iliac arteries. From January 1995 through May 2000, 183 patients having chronic lower limb arterial insufficiency who underwent duplex scanning of the lower extremity arteries with available aortoiliac scans within 3 months before conventional aortoiliac diagnostic angiography and/or endovascular intervention of the iliac arteries were studied retrospectively. The findings obtained from duplex scanning and angiography were analyzed in a blinded manner by 2 investigators. Limbs having category 1, 2, and 3 lesions according to duplex scan findings were interpreted as being suitable for endovascular intervention. The comparison between duplex scan findings and angiography was analyzed by the third investigator.

During 93 percutaneous transluminal angioplasty (PTA) procedures, 133 arterial segments, common or external iliac, were dilated with stent placement in 70. Bilateral interventions were performed in 25 cases, and of 68 unilateral interventions, 57 were at only 1 arterial segment. The accuracy, sensitivity, specificity, and negative and positive predictive values of duplex scanning to appropriately categorize the iliac artery lesions into suitable or unsuitable for endovascular intervention were 90%, 95%, 83%, 90%, and 92%, respectively when the inconclusive duplex scans were excluded (11%). In 6 patients with lesions suitable for PTA according to duplex scanning and angiography, PTA was not performed owing to clinical reasons. The accuracy of duplex scanning in predicting the performance of endovascular intervention was 88%.

It is concluded that iliac artery endovascular procedures in limbs with chronic occlusive disease can be reliably planned according to duplex scan findings.

Vascular and Endovascular Surgery, Vol. 35, No. 6, 437-442 (2001)
DOI: 10.1177/153857440103500603


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?