Non-invasive femoropopliteal assessment: is that angiogram really necessary?

Shearman, CP; Gwynn, B.R.; Curran, F. T.; Gannon, Mark Xavier; Simms, M. H.

doi:10.1136/bmj.293.6554.1086

Cited by 31 publications

(5 citation statements)

References 7 publications

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“…The combined preoperative predictions of colour-coded duplex imaging and dependent Doppler insonation obviated the need for preoperative arteriography. This agrees with previous studies that have stated that preoperative diagnostic arteriography is unnecessary for patients before femorodistal bypass grafting 8,11 . The results question whether intraoperative arteriography is necessary.…”

Section: Discussionsupporting

confidence: 93%

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Colour–coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels

McCarthy

Nydahl

Hartshorne

et al. 1999

Journal of British Surgery

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Section: Discussionsupporting

confidence: 93%

“…This study supports the ®ndings of others 8,9,11 that duplex ultrasonography and Doppler insonation are as good as diagnostic arteriography for imaging and assessing the cruropedal vessels before bypass surgery. A large prospective randomized study is needed to con®rm that preoperative angiography is unnecessary; to date none exists.…”

Section: Discussionsupporting

confidence: 91%

Colour–coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels

McCarthy

Nydahl

Hartshorne

et al. 1999

Journal of British Surgery

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“…In the present study, the researchers modified these methods and evaluated the data of color DUSs and/or angiographies of 86 patients. Although ankle: brachial pressure scorings were shown to be in close correlation with arteriographic scorings [ 16 ], the researchers preferred to use the flow characteristics of the arterial DUS data because of the unreliability of the Doppler-derived ankle: brachial index depending on arterial media calcification of diabetic vascular disease [ 21 ]. Furthermore, angiographic scoring degrees were inverted to synchronize the values obtained from color DUS.…”

Section: Discussionmentioning

confidence: 99%

Role of Comorbidities as Limiting Factors to the Effect of Hyperbaric Oxygen in Diabetic Foot Patients: A Retrospective Analysis

2014

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IntroductionThe effectiveness of hyperbaric oxygen therapy (HBOT) on selected diabetic foot wounds continues to be controversial. A holistic approach to diabetes and its comorbidities may be beneficial in the discussion of the proper application of this treatment modality. The aim of the current study is to evaluate the efficacy of HBOT on diabetic foot wounds and provide clinical data that may support this knowledge.MethodsThe present study was a retrospective analysis of the effect of HBOT on diabetic foot lesions ranging 3–5 on the Wagner Grading System. Patients had been treated with HBOT and monitored for 12 months. The results were analyzed in relation to age, gender, diabetes duration and type, microangiopathic complications, peripheral arterial disease (PAD), history of coronary artery disease, stroke, hypertension, smoking habits, glycated hemoglobin, blood sedimentation rate, C-reactive protein, and number of HBOT sessions. Microangiopathies were evaluated as retinopathy, nephropathy, and neuropathy. PAD was determined by available color Doppler ultrasonography and/or angiographic data depending on a modified scoring system. The data of arteries from the aorta to the dorsal pedal artery were scored singly. Average scores of aorto-iliac, femoral, popliteal and pedal levels were also evaluated with this system to compare the healing results in relation to PAD.ResultsOne hundred and seventeen patients with 126 diabetic foot wounds were treated. Histories of coronary artery disease, stroke, and non-proliferative or proliferative retinopathy had negative effects on HBOT (P = 0.002, P = 0.015, P = 0.022, respectively). Depending on the scorings of PAD, the single arterial scores and average scores of aorto-iliac, popliteal and pedal levels had no relation to outcomes, while the average scores of the femoral arterial level affected the results (P = 0.048).ConclusionsDiabetic foot patients with histories of coronary artery diseases or stroke and non-proliferative or proliferative retinopathy might resist HBOT. PAD at the femoral arterial level has been shown to have a significant negative effect on HBOT outcomes that should be first considered for surgery. In contrast, PAD below the knee does not seem to be an obstacle to the efficacy of HBOT.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-014-0085-8) contains supplementary material, which is available to authorized users.

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“…13 Surgical technique. The femoropopliteal component of the graft was performed with an 8-mm polytetrafluororethylene prosthesis routed through a subsartorial tunnel.…”

Section: Methodsmentioning

confidence: 99%

Composite sequential grafts for femorocrural bypass reconstruction: Experience with a modified technique

Mahmood

Garnham

Sintler

et al. 2002

Journal of Vascular Surgery

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Non-invasive femoropopliteal assessment: is that angiogram really necessary?

Cited by 31 publications

References 7 publications

Colour–coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels

Colour–coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels

Role of Comorbidities as Limiting Factors to the Effect of Hyperbaric Oxygen in Diabetic Foot Patients: A Retrospective Analysis

Composite sequential grafts for femorocrural bypass reconstruction: Experience with a modified technique

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