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Titolo:
Duplex scanning allows selective use of arteriography in the management ofpatients with severe lower leg arterial disease
Autore:
Koelemay, MJW; Legemate, DA; de Vos, H; van Gurp, AJ; Balm, R; Reekers, JA; Jacobs, MJHM;
Indirizzi:
Univ Amsterdam, Acad Med Ctr, Dept Vasc Surg, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands Univ Amsterdam, Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands Univ Amsterdam Amsterdam Netherlands NL-1105 AZ Z Amsterdam, Netherlands
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 4, volume: 34, anno: 2001,
pagine: 661 - 667
SICI:
0741-5214(200110)34:4<661:DSASUO>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
GENERATED RUN-OFF; INFRAPOPLITEAL BYPASSES; FEMOROPOPLITEAL ARTERY; ULTRASONOGRAPHY; ANGIOPLASTY; ANGIOGRAPHY; SURGERY; ISCHEMIA; RECONSTRUCTION; POPLITEAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
23
Recensione:
Indirizzi per estratti:
Indirizzo: Legemate, DA Univ Amsterdam, Acad Med Ctr, Dept Surg G4 111, Meibergdreef 9,POB 22700, NL-1100 DE Amsterdam, Netherlands Univ Amsterdam Meibergdreef 9,POB 22700 Amsterdam Netherlands NL-1100 DE
Citazione:
M.J.W. Koelemay et al., "Duplex scanning allows selective use of arteriography in the management ofpatients with severe lower leg arterial disease", J VASC SURG, 34(4), 2001, pp. 661-667

Abstract

Purpose: Until April 1997 we routinely performed intra-arterial digital subtraction angiography (iaDSA) in all patients with severe lower leg ischemia requiring intervention. After a comparative study of duplex scanning (DS), pulse-generated runoff, and iaDSA of the lower leg arteries, we postulated that management could be based on DS/pulse-generated runoff in 59% of patients. We prospectively evaluated the safety of such a noninvasive workup, strategy. Methods. All consecutive patients referred with severe lower leg ischemia between April 1997 and September 1998 were eligible. Management was based on DS with iaDSA being performed only on indication. Complications within 30days and 12- and 24-month patency, survival, and limb salvage rates were recorded and compared with historical controls. Results: A total of 125 limbs in 114 patients were evaluated (74% rest pain or tissue loss). In 97 (78%) of 125 limbs, management was based on DS. Itcomprised conservative treatment (n=33, 0% after iaDSA), percutaneous transluminal angioplasty (n=25, 16% iaDSA), femoropopliteal bypass graft (n=29,17% iaDSA), femorotibial bypass graft (n=29, 62% iaDSA), and other surgical procedures (n=8, 4% iaDSA). Overall, the mortality within 30 days was 4% (5/114), and 2-year survival was 83%. Two-year primary and secondary patency and limb salvage rates were 75%, 93%, and 93% after a femoropopliteal bypass operation, respectively. One-year primary and secondary patency and limb salvage rates were 35%, 73%, and 74%, respectively, after a femorocrural bypass operation. There were no differences in patient characteristics, indication for specific treatment, and immediate and intermediate term outcomebetween the study and reference population. Conclusion: In a vascular unit with wide expertise in DS of the lower leg arteries, management of patients with severe lower leg ischemia can be based on DS in most patients without negative effects on clinical outcome within 30 days and at 2-years' follow-up.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 07:07:00