Document Detail


Internal thoracic artery-inferior epigastric artery as a collateral pathway in aortoiliac occlusive disease.
MedLine Citation:
PMID:  16616225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In patients with aortoiliac occlusion, the internal thoracic artery-inferior epigastric artery (ITA-IEA) collateral is one of the collaterals supplying blood flow to the lower extremity, and the interruption of this collateral may cause severe leg ischemia. The aim of this study was to evaluate by color duplex ultrasonography scans the ITA-IEA pathway and its significance as a collateral in providing lower-extremity perfusion in aortoiliac occlusive disease.
METHODS: Color duplex ultrasonography scans were prospectively performed in 64 consecutive patients with aortoiliac occlusion. Blood flow measurement in the ITA, IEA, and common femoral artery was done on both sides. The patients were stratified according to occlusion level (aorta, common iliac artery, external iliac artery), and the data obtained from such groups were compared.
RESULTS: In 95% of patients with aortoiliac occlusion, the ITA-IEA pathway was functioning as a collateral, with mean collateral flow of 66 +/- 48 mL/min, and its average contribution to lower-extremity perfusion was 38% +/- 23%. Additionally, a moderately positive correlation was found between flows of ITA and IEA (r = 0.55, P < .0001). Depending on the level of occlusion, the collateral flow and its contribution to perfusion progressively decreased from the proximal to distal aortoiliac occlusion level. Furthermore, the difference in the ITA-IEA flow volume was statistically significant between occlusion levels (P = .009), but the differences in the perfusion contribution were not different among levels (P = .311). There was also no statistical difference between the groups concerning collateral flow volume and contribution to lower-extremity perfusion in relation to unilateral or bilateral occlusion of the iliac artery, the state of distal run-off being good or poor, or the clinical findings being mild or severe.
CONCLUSION: In patients with aortoiliac occlusion, the ITA-IEA collateral pathway is an important route providing lower-extremity perfusion. Additionally, Doppler sonographic flow measurements of the contribution of the ITA-IEA route to lower-extremity perfusion may provide beneficial diagnostic information necessary for the pretreatment work-up of patients with aortoiliac occlusion, especially for whom the ITA is planned to be used as a coronary artery graft.
Authors:
Mehmet Yurdakul; Muharrem Tola; Ensar Ozdemir; Murat Bayazit; Turhan Cumhur
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  43     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-17     Completed Date:  2006-05-17     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:  707-13     Citation Subset:  IM    
Affiliation:
Department of Radiology, Türkiye Yüksek Ihtisas Hospital, Sihhiye Ankara, Turkey. myurdakul@tyih.gov.tr
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MeSH Terms
Descriptor/Qualifier:
Angiography / methods
Aorta, Abdominal / physiopathology,  ultrasonography
Arterial Occlusive Diseases / radiography,  ultrasonography*
Collateral Circulation / physiology*
Epigastric Arteries / ultrasonography*
Female
Humans
Iliac Artery / physiopathology,  ultrasonography
Lower Extremity / blood supply
Male
Mammary Arteries / ultrasonography*
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Ultrasonography, Doppler, Color*
Vascular Patency / physiology

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


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