Surveillance Duplex Ultrasonography of Stent Grafts for Popliteal Aneurysms

被引:3
作者
Pineda, Danielle M. [1 ]
Troutman, Douglas A. [1 ]
Dougherty, Matthew J. [1 ]
Calligaro, Keith D. [1 ]
机构
[1] Penn Hosp, Vasc Surg Sect, Philadelphia, PA 19107 USA
关键词
popliteal aneurysm; duplex ultrasonography; stent graft; ARTERY ANEURYSM; OUTCOMES; REPAIRS;
D O I
10.1177/1538574416642872
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: Stent grafts, also known as covered stents, have become an increasingly acceptable treatment for popliteal artery aneurysms. However, endovascular exclusion confers lower primary patency compared to traditional open bypass and exclusion. The purpose of this study was to evaluate whether duplex ultrasonography (DU) can reliably diagnose failing stent grafts placed for popliteal artery aneurysms prior to occlusion. Methods: Between June 5, 2007, and March 11, 2014, 21 stent grafts (Viabahn; Gore, Flagstaff, Arizona) were placed in 19 patients for popliteal artery aneurysms. All patients had at least 1 follow-up duplex scan postoperatively. Mean follow-up was 28.9 months (9-93 months). Postoperative DU surveillance was performed in our Intersocietal Accreditation Commission noninvasive vascular laboratory at 1 week postprocedure and every 6 months thereafter. Duplex ultrasonography measured peak systolic velocities (PSVs) and ratio of adjacent PSVs (Vr) every 5 cm within the stent graft and adjacent arteries. Results: We retrospectively classified the following factors as abnormal DU findings: focal PSV > 300 cm/s, uniform PSVs < 50 cm/s throughout the graft, and Vr > 3.0. These DU criteria were derived from laboratory-specific data that we previously published on failing stent grafts placed for lower extremity occlusive disease. Four of the 21 stent grafts presented with symptomatic graft thrombosis within 6 months of a normal DU. Three of these 4 patients presented with rest pain and underwent thrombectomy (2) or vein bypass (1), and 1 elected for nonintervention for claudication. Conclusion: Our results suggest that surveillance DU using criteria established for grafts placed for occlusive disease may not be useful for predicting stent graft failure in popliteal artery aneurysms.
引用
收藏
页码:231 / 234
页数:4
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