Radiology, Vol 176, 39-44, Copyright © 1990 by Radiological Society of North America
Evaluation of the peripheral arteries with duplex US after angioplasty
D Sacks, ML Robinson, DL Marinelli and GS Perlmutter
Department of Radiology, Reading Hospital and Medical Center, PA 19603.
Duplex ultrasound (US) was performed in 22 patients before and immediately
after percutaneous transluminal balloon angioplasty (PTA) for peripheral
artery stenoses or occlusions. Two patients underwent PTA on two occasions,
and one patient underwent PTA of each lower extremity, resulting in 25
duplex US imaging pairs at a total of 40 PTA sites. The criterion for
significant stenosis on duplex US studies was an increase in peak systolic
velocity of at least 100% compared with the velocity in the arterial
segment proximal to the lesion (velocity ratio, greater than or equal to
2.0). For 22 paired duplex US studies, pulse volume recordings or
ankle-brachial indexes were obtained before and after PTA. After PTA, eight
patients had residual high velocity ratios at 12 PTA sites. Only two of
these patients had a residual hemodynamic stenosis as determined with
post-PTA arteriography, pulse volume recordings, or ankle-brachial indexes.
In this study, duplex US that was performed immediately after PTA for
evaluation of residual stenosis was frequently misleading.
