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首页> 外文期刊>Journal of endovascular surgery: the official journal of the International Society for Endovascular Surgery >Angioplasty of lower limb arterial stenoses under ultrasound guidance: single-center experience.
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Angioplasty of lower limb arterial stenoses under ultrasound guidance: single-center experience.

机译：超声引导下肢血管狭窄的血管成形术：单中心经验。

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PURPOSE: To examine the feasibility and utility of ultrasound-guided angioplasty for treating lower limb stenoses. METHODS: Duplex ultrasonography was employed to guide 55 balloon dilation procedures (27 iliac, 26 superficial femoral, 1 profunda, and 1 vein graft) with the help of a special ultrasound catheter (EchoMark). Ultrasound was used to determine balloon size, monitor guidewire passage, direct the dilation, and judge procedural success. Angiography was performed prior to the procedure to confirm preprocedural ultrasound findings and afterward to compare with duplex visual and hemodynamic parameters of success (peak systolic velocity ratio < 2.0). RESULTS: The balloon size determined from duplex measurements correlated in all cases with sizes selected based on the angiographic image. Guidewire visualization was possible in 95% of the cases. Angioplasty using ultrasound alone was feasible in 84%; inability to obtain a satisfactory image owing to vessel tortuosity, calcification, and bowel gas accounted for the failures. Against the duplex success criterion, initial completion angiograms had an accuracy of 76%, sensitivity of 76%, and specificity of 100%. The additional time for ultrasound guidance averaged 42 +/- 12 minutes for all cases. CONCLUSIONS: Our results show that ultrasound guidance is feasible in routine clinical practice. In this series of well-selected cases of arterial stenoses, angioplasty was performed safely using ultrasound guidance alone in over 80% of the cases. Fluoroscopic monitoring is needed when ultrasound visualization is suboptimal.
机译：目的：探讨超声引导下血管成形术治疗下肢狭窄的可行性和实用性。方法：在特殊的超声导管（EchoMark）的帮助下，采用双工超声检查引导55个球囊扩张手术（27个，26个股浅表，1个深部和1个静脉移植物）。超声用于确定球囊大小，监测导丝通过，指导扩张并判断手术成功与否。术前先行血管造影以确认术前超声检查结果，然后再与双眼成功的视觉和血液动力学参数进行比较（峰值收缩速度比<2.0）。结果：在所有情况下，由双相测量确定的球囊大小与基于血管造影图像选择的大小相关。在95％的病例中，可以进行Guidewire可视化。仅使用超声的血管成形术是可行的，占84％。由于血管曲折，钙化和肠气的原因，无法获得令人满意的图像是造成这种故障的原因。根据双工成功标准，初始完成血管造影照片的准确度为76％，敏感性为76％，特异性为100％。在所有情况下，超声引导的额外时间平均为42 +/- 12分钟。结论：我们的结果表明超声引导在常规临床实践中是可行的。在这一系列精心挑选的动脉狭窄病例中，超过80％的病例仅使用超声引导就可以安全地进行血管成形术。当超声显示效果欠佳时，需要进行荧光检查。

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