Strauss A L, Schäberle W, Rieger H, Neuerburg-Heusler D, Roth F J, Schoop W
Abteilung für Innere Medizin und Radiologie der Aggertalklinik Engelskirchen.
Z Kardiol. 1989 Sep;78(9):567-72.
In case of occlusion of the superficial femoral artery (SFA), the deep femoral artery (DFA) supplies the entire lower extremity. Not infrequently, the SFA occlusion is associated with stenosis of the origin of the DFA. The angiographic study of the origin of DFA is often unsatisfactory. The purpose of the present study was to develop objective criteria for the diagnosis of the DFA origin stenosis by duplex scanning. In 60 patients, we examined 75 femoral bifurcations by duplex scanning and compared them with the independently performed angiography. Group 1 (n = 20 DFA origins) consisted of 10 normal individuals. Group 2 (n = 30 DFA origins) consisted of 25 patients with angiographically proven SFA occlusion and normal DFA. Group 3 (n = 25 DFA origins) consisted of 25 patients with angiographically proven SFA occlusion and DFA orifice stenosis. We measured the maximal systolic and mean flow velocity in the orifice of the DFA at rest and during the maximal hyperemia following 3 min of ischemia of the lower leg. At rest, the maximal flow velocity in groups 1-3 was 60 +/- 15, 142 +/- 44, and 255 +/- 60 cm/s (p less than 0.01) and the mean flow velocity was 8 +/- 6, 32 +/- 9, and 96 +/- 42 cm/s (p less than 0.01). During hyperemia, the maximal and mean flow velocity for groups 1-3 was 59 +/- 15, 155 +/- 42, and 286 +/- 82 cm/s (p less than 0.01) and 8 +/- 5, 55 +/- 19, and 144 +/- 51 cm/s (p less than 0.01), respectively. An origin stenosis of the DFA is highly probable when at rest the mean and maximal velocity in the proximal DFA exceed 50 cm/s and 180 cm/s, respectively. These results show that duplex scanning is able to detect safely DFA origin stenosis. The increase in postischemic DFA flow velocity when SFA occlusion is present, helps to evaluate total flow resistance of the deep-outflow channels (run-off) thereby being useful in planning appropriate therapy.
在股浅动脉（SFA）闭塞的情况下，股深动脉（DFA）供应整个下肢。SFA闭塞常常与DFA起始部狭窄相关。DFA起始部的血管造影研究常常不尽人意。本研究的目的是通过双功扫描制定DFA起始部狭窄诊断的客观标准。我们对60例患者的75个股动脉分叉进行了双功扫描，并与独立进行的血管造影进行比较。第1组（n = 20个DFA起始部）包括10名正常个体。第2组（n = 30个DFA起始部）包括25例经血管造影证实SFA闭塞且DFA正常的患者。第3组（n = 25个DFA起始部）包括25例经血管造影证实SFA闭塞且DFA开口狭窄的患者。我们测量了DFA开口处静息时以及小腿缺血3分钟后最大充血时的最大收缩期和平均流速。静息时，第1 - 3组的最大流速分别为60±15、142±44和255±60 cm/s（p＜0.01），平均流速分别为8±6、32±9和96±42 cm/s（p＜0.01）。充血时，第1 - 3组的最大和平均流速分别为59±15、155±42和286±82 cm/s（p＜0.01）以及8±5、55±19和144±51 cm/s（p＜0.01）。当静息时DFA近端的平均流速和最大流速分别超过50 cm/s和180 cm/s时，DFA起始部狭窄的可能性很大。这些结果表明双功扫描能够安全地检测出DFA起始部狭窄。存在SFA闭塞时缺血后DFA流速的增加有助于评估深部流出通道（侧支循环）的总血流阻力，从而有助于规划合适的治疗方案。
