Wolosker N, Rosoky R A, Nishinari K, Nakano L
School of Medicine, Universidade de São Paulo, Brazil.
Sao Paulo Med J. 2001 Mar;119(2):59-61. doi: 10.1590/s1516-31802001000200004.
Many patients with intermittent claudication continue to be forwarded to the vascular surgeon for initial evaluation after arteriography has already been accomplished.
The main objective of this work was to analyze the usefulness and the need for this procedure.
Retrospective study.
The patients were divided into two groups: Group 1, with the arteriography already performed and Group 2 without the initial arteriography.
One hundred patients with intermittent claudication were retrospectively studied. Other specialists had forwarded them for the first evaluation of intermittent claudication, without any previous treatment.
All patients were treated clinically for at least a 6-month period. The total number of arteriographies performed in the two groups was compared and the need and usefulness of the initial arteriography (of Group 1) was also analyzed.
The evolution was similar for both groups. The total number of arteriographies was significantly higher in Group 1 (Group 1 with 53 arteriographies vs. Group 2 with 7 arteriographies). For this group, it was found that arteriography was only useful in five cases (10%), because the surgeries were based on their findings. However, even in those cases, no need for arteriography was observed, as the procedure could have been performed at the time of surgical indication.
There are no indications for arteriography in the early evaluation of patients with intermittent claudication, because it does not modify the initial therapy, independent of its result. In cases where surgical treatment is indicated, this procedure should only be performed prior to surgery.
许多间歇性跛行患者在已经完成动脉造影后仍被转诊至血管外科医生处进行初始评估。
这项工作的主要目的是分析该检查的实用性和必要性。
回顾性研究。
患者被分为两组:第1组,已进行动脉造影;第2组,未进行初始动脉造影。
对100例间歇性跛行患者进行回顾性研究。这些患者此前未经任何治疗,由其他专科医生转诊来进行间歇性跛行的首次评估。
所有患者均接受了至少6个月的临床治疗。比较两组进行动脉造影的总数,并分析初始动脉造影(第1组)的必要性和实用性。
两组的病情进展相似。第1组动脉造影的总数显著高于第2组(第1组53次动脉造影,第2组7次动脉造影)。对于该组患者,发现动脉造影仅在5例(10%)中有用,因为手术是基于造影结果进行的。然而,即使在这些病例中,也未观察到有进行动脉造影的必要,因为该检查本可在手术指征明确时进行。
在间歇性跛行患者的早期评估中,没有进行动脉造影的指征,因为无论其结果如何,该检查都不会改变初始治疗方案。在有手术治疗指征的情况下,该检查应仅在手术前进行。