Ramaswami G, al-Kutoubi A, Nicolaides A N, Geroulakos G, Ferrara-Ryan M, Aref F, Labropoulos N, Sutton G
Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St. Mary's Hospital, London, U.K.
Eur J Vasc Surg. 1994 Jul;8(4):457-63. doi: 10.1016/s0950-821x(05)80965-x.
Duplex examination was carried out to assess lesions in peripheral arteries amenable to angioplasty. With the help of a special catheter, angioplasty of these lesions was performed under Duplex control. Sixteen patients presenting with claudication were examined by Duplex and 38 lesions were identified (31 stenoses, seven occlusions) and all the findings except one (vessel E1) were confirmed by subsequent angiography. Sixteen lesions were considered amenable to angioplasty and 13 lesions (in 10 patients) were selected for Duplex controlled angioplasty. A new catheter system which has a piezo-electric transducer at the centre of the balloon and integrated to a Duplex scanner via a catheter system interface, was used for the procedure. This allows the exact position of the balloon to be represented on the screen. Thirteen lesions (seven superficial femoral artery (SFA), three external iliac, two common iliac and one graft) were subjected to angioplasty under Duplex control. In one patient, the SFA was punctured directly under ultrasound control as the profunda was diseased. The guide wire was visualised in all cases and in the majority of cases, balloon size for the angioplasty was chosen by measurement of the arterial diameter by Duplex, which was also used for haemodynamic evaluation before, during and after the procedure. Eleven lesions (85%) underwent angioplasty entirely under Duplex control and additional X-ray control was needed in only two cases. In conclusion, Duplex allows the monitoring of both anatomical and haemodynamic parameters during angioplasty. It also reduces the risk of ionising radiation. Our initial experience has been encouraging as angioplasty was performed in the majority of lesions purely under Duplex control.
进行双功超声检查以评估适合血管成形术的外周动脉病变。借助特殊导管，在双功超声引导下对这些病变进行血管成形术。对16例有间歇性跛行的患者进行双功超声检查，发现38处病变（31处狭窄，7处闭塞），除一处病变（血管E1）外，所有检查结果均经后续血管造影证实。16处病变被认为适合血管成形术，其中13处病变（10例患者）被选作双功超声引导下的血管成形术。手术使用了一种新的导管系统，该系统在球囊中心有一个压电换能器，并通过导管系统接口与双功超声扫描仪相连。这使得球囊的精确位置能够显示在屏幕上。在双功超声引导下对13处病变（7处股浅动脉、3处髂外动脉、2处髂总动脉和1处移植物）进行了血管成形术。1例患者因股深动脉病变，在超声引导下直接穿刺股浅动脉。所有病例均能看到导丝，大多数情况下，通过双功超声测量动脉直径来选择血管成形术所用球囊的大小，双功超声还用于手术前、手术中和手术后的血流动力学评估。11处病变（85%）完全在双功超声引导下完成血管成形术，仅2例需要额外的X线引导。总之，双功超声能够在血管成形术期间监测解剖和血流动力学参数。它还降低了电离辐射风险。我们的初步经验令人鼓舞，因为大多数病变的血管成形术纯粹在双功超声引导下完成。
