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Colour-coded duplex imaging and dependent Doppler ultrasonography in the assessment of cruropedal vessels

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Background: It has been suggested that ultrasonography could replace diagnostic arteriography in the assessment of patients who present with leg ischaemia. This study investigated a group of consecutive patients who had femorodistal bypass and who were assessed before operation with colour-coded duplex and dependent Doppler insonation alone.

Methods: Thirty-seven consecutive patients with critical lower limb ischaemia underwent surgical exploration with a view to femorodistal bypass. Results of preoperative colour-coded duplex and dependent Doppler insonation were compared with intraoperative arteriograms and surgical findings.

Results: There was very good agreement between colour-coded duplex imaging and dependent Doppler insonation with intraoperative angiography and surgical findings in the prediction of the optimal run-off vessel (κ = 1·0) and the site of the distal anastomosis (κ = 0·85; 95 per cent confidence interval 0·71–1·0). There was also very good agreement between dependent Doppler insonation and intraoperative arteriography (κ = 1·0) in predicting pedal arch patency and the predominant feeding vessel.

Conclusion: Assessment of leg arteries before femorodistal bypass can be performed accurately with non-invasive colour-coded duplex imaging and dependent Doppler insonation alone, thus obviating the need for preoperative arteriography.
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Document Type: Research Article

Affiliations: Department of Surgery, Robert Kilpatrick Clinical Science Building, University of Leicester, Leicester LE2 7LX, UK

Publication date: January 1, 1999

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