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Ultrasonic Duplex Scanning in the Evaluation of Arterial Grafts and Dilatations
Author(s) -
BANDYK DENNIS F.
Publication year - 1987
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.1987.tb01336.x
Subject(s) - medicine , duplex scanning , stenosis , radiology , hemodynamics , ultrasound , angiography , duplex (building) , abdominal aorta , cardiology , aorta , dna , genetics , biology
Summary The progressive decline in patency of arterial bypasses and dilatations with time mandates a protocol of noninvasive testing for surveillance. The majority of patients requiring revision are asymptomatic and, therefore, screening with angiography is not warranted. With the development of the duplex scanner, a method is available that provides both anatomical and physiological information of arterial reconstructions. The technique permits a quantitative evaluation of the velocity waveform in arterial grafts and dilatations. Flow velocity in grafts can be calculated and used as a prognostic indicator of patency. A low graft flow velocity (peak systoloic velocity &< 45 cm/sec) indicates that graft patency is threatened and should prompt a complete evaluation. The ability to image the arterial system from the abdominal aorta to the tibial arteries permits precise localization of disease, detection of correctable graft lesions, and better selection of patients for arteriography. Approximately 5% of patent lower limb bypasses per year will be identified to have a hemodynamic abnormality that warrants correction. Duplex scanning is also ideally suited for the evaluation of transluminal angioplasty sites. Vessel patency and stenosis severity can be assessed based on the velocity spectra. Careful surveillance of arterial grafts and dilatations is rewarded by improved patency and the continued relief of limb ischemia.