Doppler ultrasound combined with intravascular ultrasound-guided lower limb arterioplasty and stenting for occlusive femoropopliteal artery disease

Abstract

Abstract Purpose Endovascular therapies have become common clinical treatment modalities for lower extremity atherosclerotic occlusion. Traditional digital subtraction angiographic images provide limited information, whereas Doppler and intravascular ultrasound, as adjunctive imaging techniques, provide real-time dynamic vascular information. The aim of this study was to investigate the feasibility, safety, and efficacy of Doppler ultrasound combined with intravascular ultrasound-guided percutaneous transluminal angioplasty for treating femoral popliteal chronic total occlusive lesions. Materials and Methods The clinical data of 13 patients (13 limbs) with chronic total occlusive lesions of the lower limb arteries who underwent Doppler ultrasound with intravascular ultrasound-guided percutaneous transluminal angioplasty at the Interventional Treatment Center were retrospectively analyzed. The primary evaluation criterion was the procedural success rate. The secondary evaluation criteria were the differences between preoperative and postoperative ankle-brachial index, blood creatinine level, and estimated glomerular filtration rate. Procedural success was defined as the placement of a guidewire through the occluded segment of the femoropopliteal artery followed by either balloon dilatation or stent placement as planned. Results All patients (100%) successfully underwent the procedure as planned. The ankle brachial index, which was 0.236 ± 0.072 preoperatively, significantly increased to 0.825 ± 0.079 after the procedure (t = 18.474, P = 0.000). The differences between the preoperative and postoperative glomerular filtration rate estimates and blood creatinine levels were not statistically significant, indicating that the procedures did not compromise renal function. Conclusion Doppler ultrasound combined with intravascular ultrasound-guided percutaneous transluminal angioplasty was a dynamic, precise, and safe regimen for treating femoral popliteal chronic total occlusive lesions.