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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2006.tde-04122006-101149
Document
Author
Full name
Fabio Henrique Rossi
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Leao, Pedro Puech (President)
Aun, Ricardo
Izukawa, Nilo Mitsuru
Nishinari, Kenji
Presti, Calogero
Title in Portuguese
Avaliação do leito arterial distal em revascularização de membros inferiores: estudo comparativo entre ecografia-doppler, arteriografia e medidas diretas de fluxo no intra-operatório
Keywords in Portuguese
Extremidade inferior
Fluxo de escoamento
Isquemia
Medição de vazão
Prognóstico
Ultra-sonografia Doppler
Abstract in Portuguese
A cirurgia de restauração circulatória arterial no paciente portador de isquemia crítica de membros inferiores apresenta indicações clínicas e técnica operatória já bastante estudadas e definidas. Ainda hoje, no entanto, um considerável número de enxertos evolui para oclusão. Entre as causas relacionadas à falência precoce, podemos destacar a resistência do leito distal receptor do enxerto. Interessou-nos estudar a existência de correlação hemodinâmica entre a Ecografia-Doppler, a Arteriografia pré-operatória, e medidas diretas intra-operatórias de resistência do leito arterial receptor do enxerto. Foram estudadas 68 operações de revascularização de membros inferiores portadores de isquemia crítica. A Ecografia-Doppler foi considerada tecnicamente satisfatória em 93,2%. Foi verificada a presença de correlação hemodinâmica positiva entre os métodos descritos acima (Teste de Pearson), particularmente para as artérias distais. Concluímos que a Ecografia-Doppler, além de definir as características anatômicas da artéria a ser revascularizada, pode auxiliar no estudo hemodinâmico do leito arterial receptor do enxerto e dessa forma auxiliar na definição do prognóstico do enxerto e no estabelecimento da melhor estratégia terapêutica a ser tomada ainda no período pré-operatório
Title in English
Color-flow duplex hemodynamic assessment of runoff in ischemic lower limb revascularization: a comparative study among preoperative duplex scanning, arteriography and intraoperative direct out flow measurements
Keywords in English
Flow measurement
Ischemia
Lower extremity
Prognosis
Runoff flow
Ultrasonography Duplex
Abstract in English
The clinical indications and the surgical technique regarding arterial revascularization in patients with critical lower limb ischemia have been thoroughly studied and well determined in the literature. However, a considerable number of grafts evolutes to occlusion even nowadays. Among the factors known to contribute to early graft failure the resistance of the outflow arterial bed stands out. The purpose of this study is to verify Duplex Scanning hemodynamic correlation power with preoperative arteriography and direct intraoperative resistance measurements. Sixty-eight (68) lower limb revascularizations were studied. Preoperative Duplex Scanning was considered satisfactory in 93,2% of the cases. A positive hemodynamic correlation among the methods described above (Pearson's correlation test), particularly for distal arteries, has been verified. We conclude that preoperative Duplex Scanning, apart from defining the anatomic characteristics of the artery to be revascularized, can be helpful in the hemodynamic study of the arterial bed receiving the graft, making it easier to establish the graft prognosis and define the best therapeutic strategy to be adopted in the preoperative period.
 
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fabiohrossi.pdf (2.22 Mbytes)
Publishing Date
2006-12-18
 
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