Infrainguinal endovascular procedures based upon the results of duplex scanning.

AIM: The aim of this study was to report the role of duplex scanning in selection of patients with lower limb ischemia for infrainguinal endovascular revascularization. METHODS: From January 2002 to December 2005, 95 patients (66 male, 29 female) underwent infrainguinal endovascular revascularization based on duplex scanning. The indications for surgery were severe claudication (11%), rest pain (15%), gangrene (40%), and non-healing ulcer (34%). RESULTS: Duplex procedure time averaged 60+/-30 min. A total of 120 arterial hemodynamic relevant lesions were treated with endovascular therapy, 47 were localized in the aorto-iliac segment, 55 in the femoro-popliteal segment and 18 were infrapopliteal. Out of a total of 120 lesions, 107 (89%) were successfully dilated; 105 lesions (88%) predicted by preoperative duplex scanning were confirmed by contrast arteriography (CA) at the time of surgery. Additional lesions were revealed by intraoperative arteriography in 15 cases (12%). The accuracy and sensitivity of duplex scanning in the selection of aorto-iliac lesions for endovascular procedures was 86%, 91% for femoro-popliteal lesions, and 78% for infrapopliteal lesions. CONCLUSION: The results of this experience show that duplex scanning may be a safe alternative to CA for patients with chronic limb ischemia. Adequate training and experience is necessary to utilize this technique for the selection of patients for infrainguinal endovascular procedures.