A Prospective Feasibility Study of Duplex Ultrasound Arterial Mapping, Digital-Subtraction Angiography, and Magnetic Resonance Angiography in Management of Critical Lower Limb Ischemia by Endovascular Revascularization

2007 ◽  
Vol 21 (4) ◽  
pp. 443-451 ◽  
Author(s):  
A.J. Lowery ◽  
N. Hynes ◽  
B.J. Manning ◽  
M. Mahendran ◽  
S. Tawfik ◽  
...  
Author(s):  
Hesham Ebrahim Ahmed Al-rudaini ◽  
Ping Han ◽  
Huimin Liang

Background:CT Angiography (CTA) of aortoiliac and lower extremity arteries is a relatively recent innovation of CT imaging that has changed after the introduction of multi-detector row scanners.Objective:The study aimed to evaluate the diagnostic accuracy of Multidetector Computed Tomographic Angiography (MDCTA) in the assessment of arterial tree in patients with Peripheral Arterial Occlusive Disease (PAOD), as compared to Digital Subtraction Angiography (DSA).Methods:A single-center nonrandomized prospective study was conducted on 50 patients complaining of peripheral arterial disease (chronic stage) from February 2017 to October 2017. All the patients were exposed to DSA and CTA prior to definitive treatment. The images were then analyzed using maximum intensity projection, volume-rendered, and curved multiplane reformation techniques.Results:All the patients involved in this study were susceptible according to their clinical presentation. The statistical analysis exposed a highly significant difference between CTA and DSA in the assessment of stenosis at the level of Femoropopliteal segment (P<0.01), while for infrapopliteal segment, there was no statistically significant difference between CTA and DSA having 8% versus 14% insignificant stenosis and 62% versus 47% significant stenosis in CTA and DSA, respectively. The overall accuracy of CT angiography in the femoropopliteal segments was 95.20% while in the infrapopliteal segment it was 94.5%.Conclusion:Multidetector CT angiography was found to be a reliable alternative mean for pathoanatomical description of the arterial lesions in critical lower limb ischemia and its subsequent management in comparison to digital subtraction angiography.


2021 ◽  
Author(s):  
Hongwei Ge ◽  
Bin Song ◽  
Xin Wang ◽  
Yunfeng Zhu ◽  
Yiming Huang ◽  
...  

Abstract Background: This study aimed to compare the clinical efficacy of digital subtraction angiography (DSA) combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia (ALI). Methods: This retrospective cohort study collected the clinical data from 125 patients (129 affected lower limbs) with ALI who underwent emergency surgery from March 2010 to November 2019. Patients were consecutively divided into Group A and Group B. Patients in Group A underwent simple arterial thrombectomy via the Fogarty catheterization. Patients in Group B underwent arterial thrombectomy, and the DSA was performed during the surgery. The differences in the success rate of primary surgery, the second intervention rate, and the amputation/mortality rate within 30-d after surgery were compared. Results: In Group A, 4 of 70 limbs (5.7%) were amputated, 54 of 70 limbs (77.1%) had improved blood flow, 14 of 70 limbs (20.0%) received a second intervention, and 3 of 68 patients (4.4%) died within 30 d. In Group B, 1 of 59 limbs (1.7%) was amputated, 56 of 59 limbs (94.9%) had improved blood flow, 3 of 59 limbs (5.1%) received a second intervention, and 2 of 57 patients (3.5%) died within 30-d. The success rate of primary surgery, the second intervention rate, and the amputation rate of Group B were significantly lower than Group A (P<0.05). Conclusion: Arterial thrombectomy combined with DSA may effectively improve the clinical efficacy of patients with ALI.


BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongwei Ge ◽  
Bin Song ◽  
Xin Wang ◽  
Yunfeng Zhu ◽  
Yiming Huang ◽  
...  

Abstract Background This study aimed to compare the clinical efficacy of digital subtraction angiography (DSA) combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia (ALI). Methods This retrospective cohort study collected the clinical data from 124 patients (128 affected lower limbs) with ALI who underwent emergency surgery from March 2010 to November 2019. Patients were consecutively divided into Group A and Group B. Patients in Group A underwent simple arterial thrombectomy via the Fogarty catheterization. Patients in Group B underwent arterial thrombectomy, and the DSA was performed during the surgery. The differences in the success rate of primary surgery, the second intervention rate, and the amputation/mortality rate within 30-days after surgery were compared. Results In Group A, 4 of 70 limbs (5.7%) were amputated, 54 of 70 limbs (77.1%) had improved blood flow, 14 of 70 limbs (20.0%) received a second intervention, and 3 of 68 patients (4.4%) died within 30 days. In Group B, 1 of 58 limbs (1.7%) was amputated, 56 of 58 limbs (96.6%) had improved blood flow, 3 of 58 limbs (5.2%) received a second intervention, and 2 of 56 patients (3.5%) died within 30-days. The success rate of primary surgery, the second intervention rate, and the amputation rate of Group B were significantly lower than Group A (P < 0.05). Conclusion Arterial thrombectomy combined with DSA may effectively improve the clinical efficacy of patients with ALI.


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