Perspectives in Vascular Surgery and Endovascular Therapy

 

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Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 19, No. 1, 6-20 (2007)
DOI: 10.1177/1531003506298080

Duplex Arteriography for Lower Extremity Revascularization

Anil P. Hingorani, MD

Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, New York, ahingorani{at}maimonidesmed.org

Enrico Ascher, MD

Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, New York

Natalie Marks, MD, RVT

Division of Vascular Surgery, Maimonides Medical Center, Brooklyn, New York

Duplex arteriography may be a potential replacement of preoperative standard contrast arteriography for peripheral arterial imaging in lower extremity revascularization procedures. In patients with chronic or acute ischemia, a well-performed duplex arteriography offers several practical advantages over contrast arteriography: it is noninvasive; it does not require nephrotoxic agents; it is portable and can be done expeditiously; color flow and waveform analysis provide a better estimation of the hemodynamic significance of occlusive disease; it allows direct visualization of the entire artery and not only of the lumen thus enabling plaque characterization; with color flow and power Doppler techniques, it is possible to identify patent arteries subjected to very low flow states; and it can detect occluded arterial aneurysms thereby avoiding unnecessary attempts at thromboembolectomies. High-quality arterial ultrasonography performed by a highly skilled and well-trained vascular technologist may represent an alternative to conventional arteriography for patients in need of primary or secondary lower extremity revascularization.

Key Words: duplex arteriograms • lower extremity revascularization


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