ARTERIAL MAPPING WITH COLOR-FLOW DUPLEX IMAGING OF THE LOWER-EXTREMITIES AFTER EXCIMER-LASER-ASSISTED ANGIOPLASTY

The purpose of the present study was to evaluate the role of color flo w duplex imaging (CFDI) in the follow-up of patients who have undergon e excimer-laser-assisted angioplasty of peripheral arteries. Sixty-one patients (40 men and 21 women) were studied (mean age +/- SD sixty-th ree +/- nine years). All patients were affected by peripheral vascular disease and, for this reason, underwent percutaneous excimer-laser-as sisted angioplasty. Digital angiography and CFDI were performed before the laser procedure. CFDI was repeated at months 1, 3, 6, 9, and 12 a fter the laser procedure, whereas angiography was repeated after twelv e months. Common, superficial, and profunda femoral arteries and popli teal arteries were visualized in looking for the presence of lesions a nd occlusions, and spectral analysis of Doppler signals was recorded. After the initial success, claudication was reported again by 9 patien ts, 7 of whom showed total occlusions. All reocclusions were discovere d by CFDI and confirmed by angiography; 3 of these 7 patients underwen t a second laser procedure. The remaining 2 symptomatic patients showe d patent vessels and did not undergo angiography. Another 9 patients r edeveloped an occlusion, unsuspected from clinical history and symptom s. All the reocclusions, confirmed by angiography, were diagnosed by C FDI. The data show that CFDI provides an accurate noninvasive techniqu e for following up patients after excimer laser angioplasty, allowing for asymptomatic reocclusions to be recognized and treated if necessar y, and permitting symptoms not due to reocclusions to be properly iden tified, thus avoiding unnecessary angiography.