Vroegindeweij D, Tielbeek A V, Buth J, van Kints M J, Landman G H, Mali W P
Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
J Vasc Interv Radiol. 1995 May-Jun;6(3):331-7. doi: 10.1016/s1051-0443(95)72817-2.
To assess the merits of clinical examination, color-flow duplex ultrasound (US), and arteriography in the follow-up of patients who have undergone femoropopliteal artery recanalization for occlusive disease.
Recanalization of the occluded femoropopliteal artery was attempted in 62 patients. Follow- up included clinical examination, ankle-brachial blood pressure measurement, and duplex US scanning at 4-month intervals during the first year, at 6-month intervals during the second year, and one a year thereafter. Failure of recanalization included substantial restenosis or reocclusion of the treated segment. Arteriography was performed at the end of the first year or earlier if recurrence was suspected. Agreement of clinical findings with those of duplex US and those of arteriography was determined with kappa statistics; a kappa value of greater than 0.75 represented excellent agreement.
Recanalization was technically successful in 51 patients (82%). Clinical patency was 63% (standard error [SE], 6%) after 1 year, 56% (SE, 7%) after 2 years, and 46% (SE, 9%) after 3 years. When technical failures were included, the patency rate at duplex US was 58% (SE, 6%) after 1 year, 40% (SE, 7%) after 2 years, and 33% (SE, 8%) after 3 years. The patency rate at arteriography was 53% (SE, 7%) after 1 year, 33% (SE, 7%) after 2 years, and 30% (SE, 8%) after 3 years. When arteriographic examination was considered the standard of reference, diagnostic accuracy in the identification of recurrent lesions was 94% at duplex US (kappa = 0.88) and 74% at clinical examination (kappa = 0.51).
Rates of restenosis or occlusion detected at follow-up with duplex US and arteriography were comparable. However, clinical examination alone helped detect fewer cases of recurrent disease.
评估临床检查、彩色血流双功能超声（US）及动脉造影在接受股腘动脉再通术治疗闭塞性疾病患者随访中的价值。
对62例患者尝试进行闭塞股腘动脉的再通术。随访包括临床检查、踝臂血压测量，以及在第一年每4个月、第二年每6个月进行一次双功能超声扫描，此后每年进行一次。再通失败包括治疗节段出现严重再狭窄或再闭塞。若怀疑复发，则在第一年末或更早进行动脉造影。采用kappa统计分析确定临床检查结果与双功能超声及动脉造影结果的一致性；kappa值大于0.75表示一致性极佳。
51例患者（82%）再通术在技术上成功。1年后临床通畅率为63%（标准误[SE]，6%），2年后为56%（SE，7%），3年后为46%（SE，9%）。若包括技术失败病例，双功能超声检查显示1年后通畅率为58%（SE，6%），2年后为40%（SE，7%），3年后为33%（SE，8%）。动脉造影显示1年后通畅率为53%（SE，7%），2年后为33%（SE，7%），3年后为30%（SE，8%）。以动脉造影检查为参考标准，双功能超声识别复发病变的诊断准确性为94%（kappa = 0.88），临床检查为74%（kappa = 0.51）。
双功能超声和动脉造影在随访中检测到的再狭窄或闭塞率相当。然而，单纯临床检查发现的复发病例较少。
