Bestimmung der Verschlußlänge in Extremitätenarterien - Farbduplexsonographie versus Angiographie

Abstract

In the management of patients with peripheral arterial occlusive disease the length and location of an arterial occlusion has an impact on the choice of the method of arterial reconstruction, i.e. percutaneous transluminal angioplasty or vascular surgery. The aim of this study was to determine the accuracy of colour-coded Doppler sonography (CDS) compared to conventional contrast arteriography in detecting the length and localisation of an occlusion in peripheral arteries. 100 legs of 94 patients (27 women, 44 to 82 years of age [mean 60.9 years] and 67 men, 21 to 78 years of age [mean 61.3 years]) with clinically suspected artery occlusion were examined prospectively with CDS before angiography and angioplasty. The exact localisation was correctly diagnosed by CDS in 95% with a high correlation (r = 0.95) of occlusion length between both methods. The sensitivity in detecting occlusions was 98% (positive predictive value 98%). It is concluded that colour-coded Doppler sonography can diagnose the length and location of an occlusion in peripheral arteries accurately and therefore can be used as a noninvasive method to select patients for further therapy management.

Periphere arterielle Verschlusskrankheit: Stellenwert der Sonografie

“…Calcifications in stenoses with acoustic shadows provide reliable information about the degree of stenosis via evaluation of the flow velocity of the poststenotic section [1,11,39]. The length and location of superficial femoral artery occlusions can be determined with a positive predictive value of 98 % [26] and thus information regarding the prognosis of conservative therapy in superficial femoral artery occlusions is provided depending on the clinical parameters in • ▶ Appendix- Table 8. There is no indication for diagnostic angiography or MR angiography in these cases (• ▶ Appendix- Fig.…”

Wertigkeit der Farbdopplersonographie in der Diagnostik der arteriellen Verschlußkrankheit der unteren Extremität

“…Nachdem sich gezeigt hatte, daB mit der FDS pathologische Befunde nachgewiesen werden konnten, die angiographisch aus verschiedenen Grunden dem Nachweis entgingen, wurden -mit Ausnahme von Verschltissen -keine falsch positiven Ergebnisse gewertet. 20,22,23,30,32,33,37]. Fur Verand eru ngen in del' Aorteneta ge, fur die Gruppe del' ::; 50 %igen Stenosen und fur nicht ste nosierende Plaques liegen keine Vergleichsstudi en vor.…”