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Monitoring Functional Patency of Percutaneous Transluminal Angioplasty
Edward V. Kinney, MD;
Dennis F. Bandyk, MD;
Mark W. Mewissen, MD;
Debra Lanza, RN;
Thomas M. Bergamini, MD;
Elliot O. Lipchik, MD;
Gary R. Seabrook, MD;
Jonathan B. Towne, MD
Arch Surg. 1991;126(6):743-747.
Abstract
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• Duplex scanning and Doppler-derived blood pressure measurements were used to serially monitor lower limb hemodynamics in 73 patients who underwent percutaneous transluminal angioplasty. Ninety percutaneous transluminal angioplasty sites judged technically satisfactory by arteriography were evaluated. Significant hemodynamic improvement was seen in 81 (90%) of the 90 limbs, although both hemodynamic and clinical improvement were achieved in only 77 (86%) limbs. Duplex scanning within 1 week of successful angioplasty identified moderate (20% to 49% diameter reduction) or severe (>50% diameter reduction) residual stenosis in 49 (63%) of 77 balloon-dilated arterial segments. The presence of a greater than 50% diameter reduction residual stenosis predicted further restenosis and late clinical failure (11% success rate at 1 year). When the degree of residual stenosis at the percutaneous transluminal angioplasty site was less than 50% diameter reduction by duplex scanning, the procedure was durable (80% success rate at 2 years), even in patients with critical ischemia, poor runoff, or diabetes mellitus.
(Arch Surg. 1991;126:743-747)
Author Affiliations
From the Surgical (Drs Kinney, Bandyk, Bergamini, and Seabrook, and Ms Lanza) and Radiology (Drs Mewissen and Lipchik) Services, Clement J. Zablocki Veterans Affairs Medical Center, and the Department of Surgery (Dr Towne), Medical College of Wisconsin, Milwaukee.
Footnotes
Accepted for publication December 8, 1990.
Read before the 14th Annual Surgical Symposium of the Association of Veterans Affairs Surgeons, Charleston, SC, May 7, 1990.
Reprint requests to Department of Surgery, Milwaukee County Medical Complex, Medical College of Wisconsin, 8700W Wisconsin Ave, Milwaukee, WI 53226 (Dr Bandyk).
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