Document Detail


Duplex ultrasound imaging to detect limb stenosis or kinking of endovascular device.
MedLine Citation:
PMID:  22341834     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We attempted to correlate duplex ultrasound (DU) findings with the clinical outcome of graft limb stenosis or kinking after endovascular aneurysm repair (EVAR).
METHODS: Between 1998 and 2010, 248 patients underwent EVAR and postoperative DU surveillance of 496 graft limbs in our accredited noninvasive vascular laboratory by one of three experienced technologists. Routine DU surveillance was performed 1 week, 6 months, and annually after EVAR. Peak systolic velocities (PSVs) were measured in the body and midportion and distal attachment site of both limbs of the graft, and adjacent PSV ratios were calculated.
RESULTS: None of 479 graft limbs with a PSV of <300 cm/s occluded during long-term follow-up (mean, 22.3 months; range, 1-123 months). Of 17 graft limbs with a PSV >300 cm/s, seven occluded (0 of 479 vs 7 of 17, P < .01; sensitivity, 100%; specificity, 98%), five underwent prophylactic intervention (mean adjacent PSV ratio, 7.3), and five (30%) remained patent without intervention (mean PSV ratio, 3.2).
CONCLUSIONS: This large series of DU surveillance for failing EVARs grafts suggests that graft limbs with PSVs <300 cm/s can be safely monitored. However, limbs with more elevated PSVs may benefit from prophylactic intervention or more frequent surveillance to prevent limb occlusion.
Authors:
Aaron S Blom; Douglas Troutman; Brian Beeman; Mark Yarchoan; Matthew J Dougherty; Keith D Calligaro
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Publication Detail:
Type:  Journal Article     Date:  2012-02-16
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-21     Completed Date:  2012-07-18     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1577-80     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA 19106, USA.
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MeSH Terms
Descriptor/Qualifier:
Aortic Aneurysm, Abdominal / surgery*
Blood Flow Velocity
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Chi-Square Distribution
Constriction, Pathologic
Endovascular Procedures / adverse effects,  instrumentation*
Graft Occlusion, Vascular / etiology,  physiopathology,  ultrasonography*
Humans
Philadelphia
Predictive Value of Tests
Prosthesis Design
Prosthesis Failure*
Regional Blood Flow
Registries
Retrospective Studies
Sensitivity and Specificity
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Duplex*
Vascular Patency

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


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