Limitations of Arteriography in Determining Operability for Femoropopliteal Occlusive Disease

Knox, W G; Finby, Nathaniel; Moscarella, Alfred A.

doi:10.1097/00000658-196504000-00004

Cited by 13 publications

(9 citation statements)

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“…Knox Patienten eine Differenz zwischen pr~operativem Angiogramm und intraoperativ . diagnostizier tem AusmaB der Arteriosklerose bestand [15,18]. Erst das intraoperativ angefertigte Angiogramm zeigt die wirklichen Abstromverh/iltnisse [5].…”

Section: Probefreilegungunclassified

“…15 Patienten muBten prim~ir amputiert werden, bei 19 Patienten wurde eine Rekonstruktion durchgeffihrt, von denen 7 Patienten sekund/ir amputiert wurden. 1979 und 1980 wurde bei 34 Patienten im Stadium 1V der chronischen AVK mit angiographisch nicht darstellbaren peripheren Gef'~iBverh/iltnissen eine Probefreilegung zur Kl~irung der Abstromsituation am Unterschenkel vorgenommen.…”

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Percutane transluminale Angioplastie vor Probefreilegung im Stadium IV der chronischen AVK

Zühlke

Sörensen

Häring

et al. 1982

Langenbecks Arch Chiv

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In 1979 and 80, 34 stage IV patients, whose vascular situation could not be sufficiently visualized by angiography, underwent exploratory exposure. In 15 patients primary amputation had to be performed, in 19 patients reconstruction was possible. 7 of these patients had to undergo secondary amputation. During the same period of time, we performed PTA in 29 stage IV patients, in whom vascular reconstruction was not practicable. In 14 patients PTA was successful, in 15 patients its performance was technically impossible or rethrombosis occurred. Although the two patient groups are not comparable because of different vascular situation, on the basis of positive experience, we recommend that a PTA be performed before exploratory exposure or amputation in stage IV.

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Section: Probefreilegungunclassified

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Percutane transluminale Angioplastie vor Probefreilegung im Stadium IV der chronischen AVK

Zühlke

Sörensen

Häring

et al. 1982

Langenbecks Arch Chiv

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“…In contrast to angiography, the ultrasonic techniques provide information about the hemodynamics of flow and the functional status of the vascular tree (7,8,9).Since 1967 we have carried out extensive investigations of the practical clinical applications of the ultrasonic flowmeter in the Hospital in Columbia, Missouri, was activated in April 1972; during the first year approximately 300 patients were examined for diagnosis and screening for vascular disease. The obvious advantage of ultrasonic flowmeter is that it is noninvasive, relatively easy to use, utilizes equipment of moderate cost, and is portable.…”

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confidence: 99%

“…In contrast to angiography, the ultrasonic techniques provide information about the hemodynamics of flow and the functional status of the vascular tree (7,8,9). The obvious advantage of ultrasonic flowmeter is that it is noninvasive, relatively easy to use, utilizes equipment of moderate cost, and is portable.…”

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confidence: 99%

Applications of the Doppler

1975

Angiology

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A number of investigators have reported on the techniques and clinical value of the Doppler ultrasonic flowmeter in evaluation of peripheral vascular disease (1, 2, 3). The obvious advantage of ultrasonic flowmeter is that it is noninvasive, relatively easy to use, utilizes equipment of moderate cost, and is portable. The technique provides both qualitative as well as quantitative data that can be applied directly to the evaluation of a patient. Ultrasonic techniques do not carry the morbidity of angiography where intimal damage may occur with resultant thrombus formation or hematoma as a direct result of the instrumentation with the radiological procedure (4, 5, 6). In contrast to angiography, the ultrasonic techniques provide information about the hemodynamics of flow and the functional status of the vascular tree (7,8,9).Since 1967 we have carried out extensive investigations of the practical clinical applications of the ultrasonic flowmeter in the Hospital in Columbia, Missouri, was activated in April 1972; during the first year approximately 300 patients were examined for diagnosis and screening for vascular disease. Thirty of these patients were found to have extensive vascular disease amenable to surgical reconstruction. Angiographic diagnosis was performed and the results of both Doppler and angiography compared. In each instance we noted that the ultrasonic diagnosis and radiologic evaluation were comparable. Sites of occlusion and stenosis were uniformly predicted by the ultrasonic technique which was confirmed by angiography. Information on the relative functional impairment as determined by data from ankle pressures, pressure gradients, velocity ratios, and qualitative evaluation of the pulse changes detected by the velocity frequency difference (fd) proved invaluable in developing the strategy of reconstructive procedures in individual cases-information not provided by angiographic studies. The point to be made here is that the diagnostic data from the ultrasonic studies were obtained by a technician who had no prior experience with peripheral vascular disease and who, after 1 month of training, was able to obtain leg pressures and other data, which were reproducible both by the technician and others. The use of paramedical personnel in obtaining such information is important as it frees the physician from the routine and allows him to apply himself with more efficiency to the patient with peripheral vascular occlusive disease. by guest on August 11, 2015 ang.sagepub.com Downloaded from

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“…Lumbar arteriography has become the definitive diagnostic technique in evaluating occlusive arterial disease of the lower extremity. However, during the last few years it hxi been pointed out that arteriography may, in some cases, give a false impression of the actual disease in the crural arteries (8,15).…”

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confidence: 99%

The Vascular Resistance in the Arteries of the Lower Leg in Normal Subjects and in Patients with Different Degrees of Atherosclerotic Disease

Lorentsen

1973

Scandinavian Journal of Clinical and Laboratory Investigation

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Blood pressure just below the knee and at the ankle, and blood flow in the calf and in the forefoot were measured at rest and during postischemic reactive hyperemia in 6 normal subjects and in 14 patients with atherosclerosis obliterans. At rest only slight differences between the calf and the ankle blood pressure were found in the normal subjects and in most of the patients. During postischemic reactive hyperemia marked pressure differences occurred, especially in the patients. No consistent difference was found in the flow resistance in the lower leg arteries between patients without and patients with significant atherosclerotic changes of the lower leg arteries, as judged from the arteriography. The study suggests that arteriography is of limited value in the evaluation of the distal vascular bed in patients with atherosclerotic obliterations. It is demonstrated that the ankle blood pressure measured at rest cannot be used as a measure for the calf blood pressurc during reactive hyperemia. The discrepancy between inflow in calf and forefoot which may be observed during reactive hyperemia can be explained by differences in the supply pressure. Norway Scand J Clin Lab Invest Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only. Scand J Clin Lab Invest Downloaded from informahealthcare.com by Mcgill University on 12/09/14 For personal use only.

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Limitations of Arteriography in Determining Operability for Femoropopliteal Occlusive Disease

Cited by 13 publications

References 1 publication

Percutane transluminale Angioplastie vor Probefreilegung im Stadium IV der chronischen AVK

Percutane transluminale Angioplastie vor Probefreilegung im Stadium IV der chronischen AVK

Applications of the Doppler

The Vascular Resistance in the Arteries of the Lower Leg in Normal Subjects and in Patients with Different Degrees of Atherosclerotic Disease

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