Document Detail


The relationship between arm-ankle pressure difference and peak systolic velocity in patients with stenotic lower extremity vein grafts.
MedLine Citation:
PMID:  8746833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship between the measured arm-ankle pressure difference (AAPD), or the ankle/arm index (AAI), and the focal peak systolic velocity (PSV) at stenotic sites of infrainguinal vein grafts has not been determined. We attempted to relate these two parameters. We used Doppler systolic pressures and duplex ultrasonography to study 35 infrainguinal vein bypass grafts followed in a surveillance protocol. The following graft groups were identified: grafts in nondiabetic patients (n = 26), grafts in diabetic patients (n = 9), nonrevised stenotic grafts (n = 14), revised stenotic grafts (n = 14), and normal grafts (n = 7). AAPD and AAI were measured in both lower extremities. Pressure gradients across graft stenoses were indirectly estimated using the modified Bernoulli equation (delta P =4V2). Measured AAPDs and estimated pressure gradients showed moderate correlation in nondiabetic (r = 0.58) and diabetic (r = 0.63) patients. Correlation was fair (r = 0.3) prior to graft revision. There was no correlation (r = 0.1) in the nonrevised stenotic grafts. For individual patients with stenotic grafts who were followed in consecutive visits, the correlation varied from none to good (r range 0.01 to 0.71). We conclude that there is a lack of consistent correlation between the measured AAPD, or AAI, and the estimated stenotic graft pressure gradient. This finding illustrates the limitation of the AAI as a monitoring test to predict failure of stenotic infrainguinal vein grafts.
Authors:
G Papanicolaou; K W Beach; R E Zierler; D E Strandness
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  9     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-09-19     Completed Date:  1996-09-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  554-60     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Washington School of Medicine, Seattle, USA.
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MeSH Terms
Descriptor/Qualifier:
Ankle / blood supply*
Arm / blood supply*
Arteriosclerosis / surgery*,  ultrasonography
Blood Pressure / physiology*
Diabetic Angiopathies / surgery,  ultrasonography
Follow-Up Studies
Graft Occlusion, Vascular / surgery,  ultrasonography*
Humans
Ischemia / surgery*,  ultrasonography
Leg / blood supply*
Postoperative Complications / surgery,  ultrasonography
Prosthesis Failure
Reoperation
Ultrasonography, Doppler, Color
Veins / transplantation*
Grant Support
ID/Acronym/Agency:
P50HL 42270/HL/NHLBI NIH HHS

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


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