Efficacy of preoperative duplex scanning in planning for infrainguinal revascularization procedures

ABSTRACT

To evaluate safety and efficacy of preoperative duplex scanning in planning for infrainguinal revascularization procedures. Thirty patients [mean age 70 years] underwent elective DSA of lower extremity arteries at the Vascular and Endovascular Surgery unit of Perugia, Italy and were included in the study. Duplex evaluation of arterial lesions was performed for the site and degree of severity. Results were compared with DSA serving as the standard reference. Our study showed that duplex was able to determine significant lesions [either critical stenosis or occluded segments] in the femoral region with an overall sensitivity and specificity of 96.5% and 93.3% respectively and 77.7% and 99.1% as the positive predictive and negative predictive values respectively. At the popliteal region, we estimated the sensitivity and specificity as 84% and 89.2% respectively and 75% and 93.5% as the positive and negative predictive values. The overall accuracy measurements of duplex scanning at the region of leg vessels were 82.9%, and 89.4% for combined anterior and posterior tibial arteries. It seems feasible to perform infrainguinal arterial reconstructions, without preoperative angiography. Technical limitations of duplex scanning leading to inaccurate assessment of the inflow and outflow arteries, or non-visualized distal runoff arteries, should prompt angiographic evaluation