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- Title
Detection of Peripheral Microemboli Through Collateral Circulation by Doppler Ultrasound Monitoring.
- Authors
Kudo, Toshifumi; Inoue, Yoshinori; Nakamura, Hiroshi; Hirokawa, Masayuki; Sugano, Norihide; Iwai, Takehisa
- Abstract
It is possible for a proximal arterial source to lead to distal atheroembolism even in the presence of chronic occlusive disease. However, no monitoring technique lias been established regarding detection of peripheral emboli through the collateral circulation in the lower limbs. We report a 60-year-old woman and a 73-year-old man with iliac stenosis and complete occlusion of the ipsilateral superficial femoral artery in whom Doppler ultrasound successfully detected micro embolic signals (ME5) at the tibioperoneal trunk during percutaneous transluminal angiopiasty CPTA) and stent placement. By means of continuous Doppler ultrasound monitoring, 29 MES were successfully detected immediately after PTA or stent placement CMESp) and 64 MES were detected immediately after the contrast medium administration (MESc). ME5c generated significantly higher intensities (median 28, range 7 to 38) as opposed to MESp (median 21, range 5 to 35, p = 0,017). In addition, the intensity of MES after present PTA (n = 8, 25 dB, 12-35 dB) and stenting (n = 18, 22 dB, 9-35 dB) was significantly higher than that of MES after poststent PTA (n = 3, 13 dB, range; 5-16 dB). respectively (p = 0.041, p = 0,034). Iliac PTA and stent placement were successful. Ankle/brachial pressure index and the symptoms improved in both patients, who showed no embolic symptoms after the procedure. This study suggested that it was possible to detect peripheral microemboli through the collateral circulation by Doppler ultrasound monitoring and that this technique would be helpful to investigate the mechanism of embolization in patients with PTA and stent placement.
- Subjects
ANGIOPLASTY; DOPPLER ultrasonography; COLLATERAL circulation; ATHEROEMBOLISM; FEMORAL artery; SURGICAL stents
- Publication
Vascular & Endovascular Surgery, 2005, Vol 39, Issue 1, p103
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/153857440503900110