A surveillance program based on duplex ultrasound testing after peripheral arterial intervention can increase long-term patency by identifying and by repairing clinical significant lesions. Its successful application requires numerous conditions regarding pathobiology of arterial repair failure and its consequences, arterial testing expertise, and durability of secondary procedures used to repair duplex-detected lesions. The methodology of surveillance should be tailored to the type of arterial intervention. Clinical reports on the efficacy of duplex ultrasound surveillance have supported its routine use, but controversy of cost-effectiveness remains. Duplex surveillance will decrease procedural primary patency, but when successful, the primary-assisted and secondary patency rates should be significantly higher than the rates when no surveillance was performed. An examination of the primary, primary-assisted, and secondary patency rates of an arterial procedure will indicate the benefit (or lack of benefit) of a surveillance program and the appropriateness of the threshold criteria used for secondary interventions.
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http://dx.doi.org/10.1177/1531003507311681 | DOI Listing |
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