Biomedical subjects

D A Legemate

Publications and source records attributed to D A Legemate.

75 records · Page 5Linked to original sources

PubMed1989

The potential of duplex scanning to replace aorto-iliac and femoro-popliteal angiography.

The ability of duplex scanning to assess haemodynamically significant lesions in the aorto-iliac and femoro-popliteal arteries was studied. Duplex scanning was prospectively and independently compared to intra-arterial digital subtraction angiography (ia. DSA) of the aorto-iliac and femoro-popliteal arteries and intra-arterial pressure measurements of the aorto-iliac tract before and after the administration of papaverine. In 40 patients 629 arterial segments were evaluated. A greater than 150% increase in peak systolic velocity had a sensitivity of 92% and a specificity of 98% in detecting greater than 50% diameter reducing lesions in the aorto-iliac arteries as compared to ia. DSA. The numbers for the femoro-popliteal arteries are 88% and 98% respectively. Detection of occlusion in the aorto-iliac arteries had a sensitivity and specificity of 100% and in the femoro-popliteal arteries 90% and 100% respectively. There was a poorer correlation between intra-arterial pressure measurements and duplex scanning or ia. DSA as compared to the correlation between ia. DSA and duplex scanning. Retrospective spectral analysis showed that an end diastolic velocity (EDV) of greater than 40 cm/s seems to be a valuable parameter to differentiate between 50% to 74% and 75% to 99% diameter reduction. It is concluded that duplex scanning can reliably differentiate between haemodynamically significant and insignificant lesions in the aorto-iliac and femoro-popliteal arteries and has the potential to replace angiography.

Angiography↗

PubMedDate not supplied

The use of color-coded duplex scanning in the selection of patients with lower extremity arterial disease for percutaneous transluminal angioplasty: a prospective study.

PURPOSE: To exploit the potential benefits of percutaneous transluminal angioplasty (PTA) in patients with short obstructive lesions in the lower extremity, it is preferable to select patients suitable for PTA before proceeding to hospital admission and angiography. The aim of this prospective study was to evaluate the role of color-coded duplex scanning in the correct selection of patients for PTA and its influence on planning the approach to the lesion. METHODS: On the basis of clinical history, physical examination, pressure indices, and ultrasound duplex scanning, 109 patients were scheduled for PTA. RESULTS: The indication for PTA was correct in 103 patients (94%), while the procedure was performed successfully in 98 patients (90%). The approach to the lesion was planned successfully in the majority of patients. CONCLUSION: This study shows that it is justifiable to plan PTA on the basis of information obtained by duplex scanning. Results of the duplex scan may guide the catheterization route.

Angiography↗

PubMedDate not supplied

Percutaneous transluminal angioplasty of peripheral bypass stenoses.

PURPOSE: To assess the success of percutaneous transluminal angioplasty (PTA) in treating peripheral bypass stenoses. METHODS: Patients who received a femoropopliteal or femorocrural bypass graft for limb ischemia were included in a duplex surveillance program. If duplex ultrasound revealed a short (<2 cm) severe (peak systolic velocity ratio >/= 4.5) stenosis, patients were scheduled for arteriography and PTA. Fifty-eight peripheral bypass stenoses in 39 grafts in 37 patients were treated with PTA. The cumulative primary patency of treated stenoses was calculated. RESULTS: During the first year after PTA 31 (53%) treated lesions remained patent, 15 (26%) lesions restenosed at a median interval of 5.0 (range 1-12) months and 4 (7%) bypasses occluded. The cumulative primary patency of 58 treated graft stenoses at 1 year was 60% [95% confidence interval (CI) 46%-74%] and 55% (95% CI 41%-70%) at 2 years. Graft body stenoses showed a better 2-year cumulative primary patency (86%; 95% CI 68%-100%) compared with juxta-anastomotic lesions (45%; 95% CI 29%-62%; p < 0.05). CONCLUSION: PTA is justifiable as the initial treatment of peripheral bypass stenoses. Nevertheless, the restenosis rate is rather high, especially in juxta-anastomotic lesions. Continuation of duplex surveillance after PTA and timely reintervention is recommended.

Aged↗