Evaluation of femoropopliteal arteries with duplex ultrasound after angioplasty. Can we predict results at one year?

Objectives: To determine if Duplex ultrasound (DUS) 1 day after percutaneous transluminal angioplasty (PTA) is prognostic for haemodynamic and clinical results at 1 year.

Design: Prospective study.

Patients And Methods: Thirty-four femoropopliteal artery segments were treated with PTA. The peak systolic velocity ratio (PSV ratio = PSV in stenosis: PSV in normal segment) was determined with DUS before PTA, 1 day after PTA and 1 year after PTA. Clinical results were assessed with the SVS/ISCVS (Society for Vascular Surgery/International Society for CardioVascular Surgery) results classification.

Results: A 1 year, clinical benefit from PTA was seen in 16 of 25 patients (64%) and haemodynamic improvement in 20 of 34 treated segments (59%). With DUS three residual stenoses were found 1 day after PTA; all occluded within 1 year. Segments with good DUS results after PTA showed haemodynamic deterioration in 30%. Clinical improvement was seen in most patients with DUS improvement, whereas no change or deterioration was found in patients with both good and poor DUS results at 1 year.

Conclusions: Residual stenosis on DUS 1 day after PTA is prognostic for failure within 1 year. However, good DUS results after PTA cannot predict haemodynamic success. Haemodynamic success at 1 year does not imply clinical success.