Modern Possibilities of Duplex Scanning in Planning and Dynamic Observations of Patients with Distal Reconstructive Operations on Lower Extrimities

Aim. To estimate possibilities of the color duplex scanning in evaluation of a shank artery status. Duplex scanning was used as an updating method required for planning of revasularizing operations on the lower extimities arteries. A study of haemodynamic in patients after femoral-tibial bypass combined with formation of arterio-venous fistula was used as prognostic criteria of bypass functioning. Materials and methods. 9 patients with occluding aterosclerotic lesions of femoral-popliteal-tibial segments were studied. 10 revascularing operations were performed: 6 external femoral-tibial bypasses and 4 femoral-tibial bypasses with formation of unloading arterio-venous fistula and application of a “Sent-Mary boot” cuff on a distal anastomosis level. Color duplex scanning and computer angiography were performed for all patients before operation and after distal arterial reconstructions. Results. Possibilities of both methods in evaluations of the status of lower extrimities arterial bed were compared and 70% coincidence were revealed. Prognostic useful factor of the bypass functioning was a volume blood velocity in bypass at middle third of leg which is equal to a sum of volume blood velocity in donor artery distal to anastomosis and volume blood velocity in unload vein proximal to anastomosis. Conclusion. Precise performance of method and duplex scanning protocol allow to evaluate not only an anatomic state of the outflow pathway but also to determine functional status of the invaded extrimity. These data may serve as a prognostic criteria of bypass functioning.

атеросклероз артерий, дистальные артериальные реконструкции, дуплексное сканирование, atherosclerosis of the arteries, distal arterial bypass, color duplex scanning

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