Role of Duplex Arteriography as the Sole Preoperative Imaging Modality Prior to Lower Extremity Revascularization Surgery in Diabetic and Renal Patients

Ascher, Enrico; Hingorani, Anil; Markevich, Natalia; Yorkovich, William; Schutzer, Richard; Hou, Alexander; Jacob, Theresa; Nahata, Suresh; Kallakuri, Sreedhar

doi:10.1007/s10016-004-0058-x

Cited by 47 publications

(29 citation statements)

References 29 publications

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“…In contrast, DUS is a noninvasive technique that can be used for screening and diagnostic purposes in place of angiography, thereby reducing angiography-related complications, especially in patients with diabetes, renal failure, or contrast allergy. 15,16 In recent years, several studies have reported on the accuracy of DUS to diagnose lesions in the femoropopliteal segment with sensitivities ranging from 60% to 90% and specificities from 43% to 100%. [6][7][8][9][10][11][12][13] Our study found a strong correlation among duplex-derived PSV and Vr and angiographic findings.…”

Section: Discussionmentioning

confidence: 99%

Utility of duplex ultrasound in detecting and grading de novo femoropopliteal lesions

Khan

Bradley

et al. 2011

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Utility of duplex ultrasound in detecting and grading de novo femoropopliteal lesions

Khan

Bradley

et al. 2011

Journal of Vascular Surgery

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“…[16][17][18] A reliable assessment of inflow and outflow arteries could be made with duplex ultrasonography even in very low-flow situations. On the basis of this experience, we suggest that DA is an effective method to make the preoperative diagnosis of thrombosed PAA and to identify the available outflow vessels for urgent revascularization.…”

Section: Discussionmentioning

confidence: 99%

Effect of Duplex Arteriography in the Management of Acute Limb-Threatening Ischemia From Thrombosed Popliteal Aneurysms

Kallakuri¹,

Ascher²,

Hingorani³

et al. 2008

Angiology

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The role of routine use of duplex arteriography to diagnose thrombosis of popliteal artery aneurysm as a cause of acute lower extremity ischemia is investigated. In all, 109 patients (group 1) from 1994 to 1997 and 201 patients from 1998 to 2001(group 2) presenting with acute limb-threatening ischemia were studied. None of the group 1 patients underwent preoperative duplex arteriography, and no diagnosis of acute popliteal artery aneurysm thrombosis was made. Ten patients with acute ischemia due to thrombosed popliteal artery aneurysm were identified in group 2 when preoperative duplex arteriography was routinely performed. Urgent revascularization was performed based on the results of duplex arteriography. Six patients had functioning bypasses with a mean follow-up of 15.6 months. There were 3 deaths, 2 within 30 days and 1 after 2(1/2) years with functioning grafts. One patient was lost to follow-up. Routine use of duplex arteriography may provide the diagnosis and may identify the available outflow vessels for popliteal artery aneurysm.

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“…[16][17][18] A reliable assessment of inflow and outflow arteries could be made with duplex ultrasonography even in very low-flow situations. 17 From this experience, we suggest that DA is an effective method to make the preoperative diagnosis of thrombosed PAA and to identify the available outflow vessels for urgent revascularization.…”

Section: Discussionmentioning

confidence: 99%

Impact of Duplex Arteriography in the Evaluation of Acute Lower Limb Ischemia from Thrombosed Popliteal Aneurysms

Kallakuri¹,

Ascher²,

Hingorani³

et al. 2006

Vasc Endovascular Surg

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Acute limb-threatening ischemia from thrombosis may be the initial presentation of popliteal artery aneurysms (PAA) and is associated with amputation rates of 20-30%. Since contrast angiography may miss the diagnosis, the authors suspect that thrombosis of PAA may be an underappreciated cause of acute ischemia. Routine use of duplex arteriography (DA) may aid in the diagnosis and may help identify the outflow vessels with improved results. One hundred and nine patients (group 1) from 1994 to 1997 and 201 patients from 1998 to 2001 (group 2) presenting with acute limb-threatening ischemia were studied. None of the group 1 patients underwent preoperative DA and no diagnosis of acute popliteal artery aneurysm thrombosis was made. Ten patients with acute ischemia due to thrombosed popliteal artery aneurysms were identified in group 2 when preoperative DA was routinely performed. Urgent revascularization based on the results from DA was performed with use of autogenous saphenous vein in all patients. Six patients had functioning bypasses with a mean follow-up of 15.6 months. There were 3 deaths, 2 within 30 days and 1 after 2(1/2) years with functioning grafts. One patient was lost to follow-up. No major amputations were performed. Incidence of thrombosed popliteal artery aneurysms as the cause of acute limb-threatening ischemia is probably underestimated. Routine use of DA may provide the diagnosis and identifies the available outflow vessels. Contrary to previously published reports, urgent revascularization of an acutely ischemic extremity from thrombosed popliteal aneurysm can provide excellent rates of limb salvage.

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Role of Duplex Arteriography as the Sole Preoperative Imaging Modality Prior to Lower Extremity Revascularization Surgery in Diabetic and Renal Patients

Cited by 47 publications

References 29 publications

Utility of duplex ultrasound in detecting and grading de novo femoropopliteal lesions

Utility of duplex ultrasound in detecting and grading de novo femoropopliteal lesions

Effect of Duplex Arteriography in the Management of Acute Limb-Threatening Ischemia From Thrombosed Popliteal Aneurysms

Impact of Duplex Arteriography in the Evaluation of Acute Lower Limb Ischemia from Thrombosed Popliteal Aneurysms

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