Document Detail


Angioplasty of lower limb arterial stenoses under ultrasound guidance: single-center experience.
MedLine Citation:
PMID:  10088890     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine the feasibility and utility of ultrasound-guided angioplasty for treating lower limb stenoses. METHODS: Duplex ultrasonography was employed to guide 55 balloon dilation procedures (27 iliac, 26 superficial femoral, 1 profunda, and 1 vein graft) with the help of a special ultrasound catheter (EchoMark). Ultrasound was used to determine balloon size, monitor guidewire passage, direct the dilation, and judge procedural success. Angiography was performed prior to the procedure to confirm preprocedural ultrasound findings and afterward to compare with duplex visual and hemodynamic parameters of success (peak systolic velocity ratio < 2.0). RESULTS: The balloon size determined from duplex measurements correlated in all cases with sizes selected based on the angiographic image. Guidewire visualization was possible in 95% of the cases. Angioplasty using ultrasound alone was feasible in 84%; inability to obtain a satisfactory image owing to vessel tortuosity, calcification, and bowel gas accounted for the failures. Against the duplex success criterion, initial completion angiograms had an accuracy of 76%, sensitivity of 76%, and specificity of 100%. The additional time for ultrasound guidance averaged 42 +/- 12 minutes for all cases. CONCLUSIONS: Our results show that ultrasound guidance is feasible in routine clinical practice. In this series of well-selected cases of arterial stenoses, angioplasty was performed safely using ultrasound guidance alone in over 80% of the cases. Fluoroscopic monitoring is needed when ultrasound visualization is suboptimal.
Authors:
G Ramaswami; A Al-Kutoubi; A N Nicolaides; S Dhanjil; D Vilkomerson; M Ferrara-Ryan; G Stansby
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of endovascular surgery : the official journal of the International Society for Endovascular Surgery     Volume:  6     ISSN:  1074-6218     ISO Abbreviation:  J Endovasc Surg     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-05-06     Completed Date:  1999-05-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9500580     Medline TA:  J Endovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  52-8     Citation Subset:  IM    
Affiliation:
Irvine Laboratory for Cardiovascular Research, Academic Surgical Unit, Imperial College School of Medicine, London, United Kingdom. ramasg01@doc.mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography
Angioplasty, Balloon / methods*
Arterial Occlusive Diseases / radiography,  therapy*,  ultrasonography
Feasibility Studies
Female
Femoral Artery* / radiography,  ultrasonography
Follow-Up Studies
Humans
Iliac Artery* / radiography,  ultrasonography
Leg / blood supply*
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Ultrasonography, Doppler, Duplex*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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