Martí Xavier, Romera Antoni, Vila Ramon, Cairols Marc A
Vascular Surgery Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain.
Ann Vasc Surg. 2012 Nov;26(8):1071-6. doi: 10.1016/j.avsg.2012.01.019. Epub 2012 Jul 25.
To assess the role of ultrasound arterial mapping in planning therapeutic options for critical limb ischemia (CLI) in diabetic patients.
This observational and comparative study included 244 patients with CLI. All participants (64% were diabetic) underwent ultrasound arterial mapping before planning surgical treatment. We established two groups: diabetic (n = 156) and nondiabetic (n = 88). Arterial mapping was divided into segments. We studied 2,021 individual segments and used arteriography when ultrasound arterial mapping was not conclusive. We compared the degree of pathology between the groups, agreement between the treatment decision made after ultrasound mapping and the final surgical decision in both groups, and agreement between ultrasound mapping and arteriography in patients who underwent both procedures.
Diabetic patients had a significantly higher degree of pathology in all segments, except the common iliac artery. Decisions made after ultrasound mapping matched the final surgical decision 90% and 94% of the time in diabetic patients and nondiabetic patients, respectively. Decisions made on the basis of ultrasound arterial mapping matched decisions made on the basis of arteriography in 86.3%.
Ultrasound arterial mapping allowed for good therapeutic planning for CLI in diabetic patients, even though these patients had more severe arterial pathology.
评估超声动脉造影在为糖尿病患者的严重肢体缺血（CLI）制定治疗方案中的作用。
这项观察性对比研究纳入了244例CLI患者。所有参与者（64%为糖尿病患者）在计划手术治疗前均接受了超声动脉造影。我们设立了两组：糖尿病组（n = 156）和非糖尿病组（n = 88）。动脉造影被分为多个节段。我们研究了2021个独立节段，当超声动脉造影结果不明确时使用血管造影术。我们比较了两组之间的病变程度、超声造影后做出的治疗决策与两组最终手术决策之间的一致性，以及接受了两种检查的患者中超声造影与血管造影之间的一致性。
除髂总动脉外，糖尿病患者所有节段的病变程度均显著更高。超声造影后做出的决策在糖尿病患者和非糖尿病患者中分别有90%和94%的时间与最终手术决策相符。基于超声动脉造影做出的决策与基于血管造影做出的决策在86.3%的情况下相符。
超声动脉造影可为糖尿病患者的CLI提供良好的治疗方案规划，尽管这些患者的动脉病变更为严重。
