Authors: Westerband, Alex; Berman, Scott S.; Brown, Amy; Quick, Rhonda C.; Mendoza, Bernardo

Source: Journal for Vascular Ultrasound, Volume 31, Number 3, September 2007 , pp. 137-141(5)

Publisher: Society for Vascular Ultrasound

Abstract:

Purpose.—We sought to determine the utility of noninvasive color-flow duplex imaging (CDI) in the detection of iliac artery stenoses or occlusions and correlate the findings of long-term color flow duplex surveillance (CFDS) to clinical outcome after percutaneous iliac interventions.

Methods.—All patients undergoing percutaneous iliac angioplasty and stenting are prospectively entered in a surveillance protocol with CFDS and ankle-brachial indices (ABIs) performed within 6 weeks, 6 months, 12 months, and every year thereafter. Preprocedural ABI and peak systolic velocity (PSV) values were compared with postprocedural values with the Student t-test. Kaplan-Meier life-table analysis was used to estimate the patency rates.

Results.—During the last 4 years, 80 patients with 112 treated iliac systems fulfilled the study criteria. A total of 68 patients (84%) had claudication, 8 (10%) had pain at rest, and 5 (6%) had a nonhealing ulcer or gangrene. The procedural success rate was 96.4%. Comparison of ABIs and PSV values before and after iliac intervention was statistically significant (p < 0.0001). Duplex scan allowed the detection and/or monitoring of abnormal velocities in 14 treated iliac arteries. Four cases (3.5%) required reintervention on previously treated iliac arteries for symptomatic restenosis and/or disease progression. Late stent occlusions were correctly identified in two cases. Primary patency, assisted primary patency, and secondary patency rates were 77%, 94%, and 96% at 4 years, respectively.

Conclusion.—CFDS allows the detection of iliac artery stenoses and is a useful tool to identify restenosis after intervention. Because of the overall excellent patency rates observed with iliac angioplasty and stenting, CFDS surveillance in the absence of symptoms may not always be necessary and its long-term use should be individualized.

Document Type: Research article

Publication date: 2007-09-01

More about this publication?

• The Journal for Vascular Ultrasound (JVU) is the official journal of the Society for Vascular Ultrasound. It consists of original scientific and educational articles, case studies, book reviews, technical reviews, ultrasound principle reviews, viewpoints, letters to the editor, and CME tests. Regular reading of JVU, published quarterly, will keep you current in your field and provide essential information that can be applied in your practice.
  
  Previously known as the Journal of Vascular Technology - View Volumes 16-26 here
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