THE VALUE OF DUPLEX SURVEILLANCE AFTER ENDOVASCULAR INTERVENTION FOR FEMOROPOPLITEAL OBSTRUCTIVE DISEASE

Objective: The objective of the present study was to assess prospectiv ely whether serial Duplex examination runs useful in identifying impen ding failure after endovascular interventions of the femoropopliteal a rteries. Setting: Non-university hospital. Prospective clinical study. Methods: 124 Patients were successfully treated by endovascular proce dures during a 5 year period. The follow-up was by colour-flow Duplex examination at fixed intervals. At similar intervals clinical examinat ion, including ankle blood pressure measurement was performed to asses s the clinical/haemodynamic status of the patients accolding to the SV S/NA-ISCVS guidelines. For the diagnosis of impending failure the Dupl ex criterion was a peak systolic velocity ratio > 2.5 and the clinical /haemodynamic criterion runs a level <+2. Actual failure of the vascul ar procedure was defined as the occurrence of an occlusion in the trea ted arterial segment or a recurrent stenosis causing symptoms severe e nough to require a reintervention. No prophylactic reinterventions wer e performed on the basis of abnormal Duplex findings alone. Results: A bnormal Duplex findings indicating restenosis were observed in 52 pati ents. Duplex abnormalities predicted treatment failure with a sensitiv ity of 86% and a specificity of 75%, while clinical/haemodynamic asses sment had it sensitivity of 93% and a specificity of 90%. The hypothet ical management outcome if Duplex surveillance had been used as a basi s for reintervention was assessed. It appeared that only one patient w ith failure would have received a redo endovascular procedure at the t ime he had a restenosis. Conclusions: Clinical/haemodynamic assessment was more useful the follow-up of endovascular interventions than Dupl ex surveillance.