Schreve Michiel A, Huizing Eline, Kum Steven, de Vries Jean-Paul P M, de Borst Gert J, Ünlü Çağdaş
Department of Surgery, Northwest Clinics, 1815 JD Alkmaar, The Netherlands.
Vascular Service, Department of Surgery, Changi General Hospital, Singapore 529889, Singapore.
Diagnostics (Basel). 2020 Sep 28;10(10):760. doi: 10.3390/diagnostics10100760.
Percutaneous deep venous arterialization (pDVA) is a developing technique for limb salvage in patients with chronic limb-threatening ischemia by creating an arteriovenous (AV) circuit. After pDVA, patency of the AV circuit is evaluated using duplex ultrasound (DUS) imaging. Peak systolic velocity (PSV) and volume flow (VF) values for maintaining a patent AV circuit are undefined; therefore, guidance about when a reintervention should be performed is lacking. The objective of this study was to interpret post-pDVA PSV and VF values in relation to AV circuit preservation. This was performed by analyzing DUS results of 22 post-pDVA patients. A total of 670 PSV and 623 VF measurements were collected. A PSV value of ≤55 cm/s and a VF value of ≤195 mL/min were found predictive for failure. The reliability of PSV and VF measurements in patent AV-circuits was good (intraclass correlation coefficient; PSV, 0.85; VF, 0.88). In conclusion, this study is the first to analyze DUS measurements in post-pDVA patients and showed that DUS can be used to anticipate for failure. The thresholds found can be used to help interpret DUS measurements in post-pDVA patients. More research in a larger patient population is needed to prospectively validate these thresholds.
经皮深部静脉动脉化（pDVA）是一种通过建立动静脉（AV）回路来挽救慢性肢体威胁性缺血患者肢体的发展中的技术。pDVA术后，使用双功超声（DUS）成像评估AV回路的通畅情况。维持AV回路通畅的收缩期峰值流速（PSV）和容积流量（VF）值尚未明确；因此，缺乏关于何时应进行再次干预的指导。本研究的目的是解读与AV回路保留相关的pDVA术后PSV和VF值。这是通过分析22例pDVA术后患者的DUS结果来进行的。共收集了670次PSV和623次VF测量值。发现PSV值≤55 cm/s和VF值≤195 mL/min可预测失败。在通畅的AV回路中，PSV和VF测量的可靠性良好（组内相关系数；PSV为0.85，VF为0.88）。总之，本研究首次分析了pDVA术后患者的DUS测量值，并表明DUS可用于预测失败。所发现的阈值可用于帮助解读pDVA术后患者的DUS测量值。需要在更大的患者群体中进行更多研究以前瞻性地验证这些阈值。
