How to define the hemodynamic significance of an equivocal iliofemoral artery stenosis: Review of literature and outcomes of an international questionnaire
| Autor: | Daf van den Heuvel, S W de Boer, study contributors, F.N. van de Vosse, Jppm de Vries, Stefan G. H. Heinen |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
diagnosis Hemodynamics Hyperemia Constriction Pathologic 030204 cardiovascular system & hematology 030230 surgery Iliac Artery Severity of Illness Index 03 medical and health sciences Peripheral arterial occlusive disease Peripheral Arterial Disease 0302 clinical medicine Predictive Value of Tests pressure measurements hemodynamic significance Medicine Analysis software Humans Radiology Nuclear Medicine and imaging Practice Patterns Physicians' equivocal stenosis business.industry Angiography Reproducibility of Results Blood Pressure Determination General Medicine Evidence-based medicine medicine.disease Prognosis iliofemoral artery stenosis Lumen Diameter Femoral Artery Stenosis medicine.anatomical_structure Regional Blood Flow Health Care Surveys Surgery Cutoff point Radiology Cardiology and Cardiovascular Medicine business Medline database Artery |
| Zdroj: | Vascular. 25(6) |
| ISSN: | 1708-539X |
| Popis: | Purpose The goal of the study was to review current literature regarding the diagnosis of equivocal (50–70%) iliofemoral artery stenosis and compare these findings with the daily practice of an international panel of endovascular experts. Methods The Medline Database was searched for relevant publications, and an electronic survey was sent to experts in the field covering the following topics: definition of an equivocal iliofemoral artery stenosis, angiographic visualization and investigation protocols of an equivocal stenosis, intra-arterial pressure measurements, and definition of hemodynamic significance of an equivocal iliofemoral artery stenosis using a physiologic measure. Results Of the 37 invited endovascular experts, 21 (53.8%) agreed to participate in the survey. Analysis of existing literature shows that the level of evidence for diagnosing equivocal iliofemoral artery stenosis is mediocre and is not being implemented by experts in the field. Conclusion Studies have shown that a stenosis of between 50% and 70% iliofemoral lumen diameter reduction shows a wide range of trans-stenotic pressure gradients. Equivocal iliofemoral artery stenosis can best be identified using three-dimensional quantitative vascular analysis software. Although evidence for a clear hemodynamic cutoff point is weak, performing trans-lesion intra-arterial pressure measurements at rest and during maximal hyperemia is preferred. Diagnosing iliofemoral artery stenosis solely on lumen diameter reduction is inadequate. |
| Databáze: | OpenAIRE |
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