Peak Systolic Velocity >125 cm/s Overdiagnoses Carotid Artery Stenosis >50% in Carotid Duplex Scan / 대한혈관외과학회지

PURPOSE: Carotid duplex scan is a frequent option for initial carotid artery evaluation. There has been debates about accuracy of peak systolic velocity (PSV) >125 cm/s, which has been used to diagnose >50% carotid artery stenosis (CAS) in most vascular laboratories. This study is conducted to evaluate PSV >125 cm/s as a diagnostic tool for 50%> CAS. METHODS: The retrospective review was done for subjects, who had PSV >125 cm/s in carotid artery screening test in == Hospital from November 2008 to June 2011. The screening study was conducted to healthy senior volunteers to screen CAS. The subject who has PSV >125 cm/s was evaluated by carotid computed tomography (CT) scan. The clinical characteristics were surveyed. RESULTS: One hundred forty seven subjects were diagnosed with CAS using duplex scan from 1,953 subjects who underwent screening tests. Twenty eight with 33 lesions underwent carotid CT scan. There were 71% hypertension, 21% diabetes mellitus, 21% ischemic heart disease, 17% lipid disorder, and 67% smoking history. Seventeen lesions showed >50% CAS while 16 showed 125 cm/s was 49% in this study. For diagnostic accuracy, diagnostic criteria should be established in each vascular lab.

Early Results of Stenting for Chronic Artherosclerotic Occlusive Disease of Superficial Femoral Artery / 대한혈관외과학회지

PURPOSE: The purpose of this study is to evaluate the results of femoral artery stenting as a treatment of femoral artery occlusive disease, and to compare the primary patency and target lesion revascularization (TLR). METHODS: A retrospective review identified 38 patients who underwent femoral artery stenting from November 2008 to December 2010 in Inha University Hospital. Each lesion was classified according to the Trans-Atlantic Inter-Society Consensus II. Demographic, preoperative, intraoperative, and postoperative variables were collected. RESULTS: Forty cases of femoral artery stenting were done for 38 patients. The indications were claudication (47.4%), rest pain (13.2%), unhealed ulcer (13.2%), and toe gangrene (26.3%). The mean age and mean body mass index (BMI) were 72.50+/-8.19 years, and 23.0+/-0.05 kg/m2. There were 57.9% diabetes mellitus, 65.8% hypertension, 44.7% ischemic heart disease, 39.5% current smoker, 71.1% hyperlipidemia, 28.9% chronic renal failure (creatinine>1.5), 23.7% obesity (BMI>25), and 10.5% stroke. The mean follow-up was 12.1+/-0.03 months. There were no in-hospital mortality and 3 complications: 1 femoral artery dissection and 2 branch perforations. Six patients died and two symptomatic stent fractures were noted during the follow-up. One years' primary patency rate and TLR rate were 81.1% and 5.5%. CONCLUSION: Femoral artery stenting showed good results and can be a reasonable option. TLR can be considered as a new standard to evaluate the endovascular treatment.

Transition of Treatment Modalities for Peripheral Arterial Occlusive Disease for the Recent 5 Years According to the TASC II Classifications in a Single Institution

PURPOSE: Endovascular treatment for peripheral arterial obstructive disease (PAOD) is replacing traditional arterial bypass in the western world. Yet there are few reports to evaluate the pattern of clinical practice pattern for PAOD in Korea. This study was conducted to evaluate the treatment pattern for PAOD between endovascular treatment and arterial bypass, and to compare their clinical characteristics. METHODS: We conducted a retrospective study on the prospectively maintained database of patients who underwent endovascular treatment and arterial bypass for PAOD from March 2005 to December 2009 in Inha University Hospital. The aortoiliac lesions and femoropopliteal lesions were categorized by the Trans Atlantic Inter-Society Consensus (TASC) II classifications. Their treatments and clinical characteristics were compared between the former period (2005~2007 y) and the latter period (2008~2009 y). RESULTS: Three hundred nine cases (178 patients) were treated for PAOD by either arterial bypass or endovascular treatment. The patients' mean age was 69.1+/-11.3 year old. There was no difference in clinical characteristics between the two periods except for age. Endovascular treatments of both aortoiliac and femoropopliteal arterial lesions were increased in the latter period (P=0.023, P<0.001). Also, the endovascular treatments were increased in the TASC C and D aortoiliac and femoropopliteal lesions in the latter period (P=0.020, P<0.001). CONCLUSION: Endovascular treatment for PAOD is increasing in clinical practice and this shows feasibility in critically ill patient with TASC C and D lesions, although arterial bypass is still important.