Therapeutic consequences of variation in intraarterial pressure measurements after iliac angioplasty

To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-se...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 1997-11, Vol.20 (6), p.426-430
Main Authors: TETTEROO, E, HAARING, C, VAN ENGELEN, A. D, VAN DER GRAAF, Y, MALI, W. P. T. M
Format: Article
Language:English
Subjects:
ACCURACY
Adult
Aged
Angioplasty, Balloon
AORTA
Arterial Occlusive Diseases - physiopathology
Arterial Occlusive Diseases - therapy
Biological and medical sciences
BIOMEDICAL RADIOGRAPHY
Blood Pressure - physiology
Diseases of the cardiovascular system
Female
Follow-Up Studies
Humans
Iliac Artery - physiopathology
Male
Medical sciences
Middle Aged
PATIENTS
PRESSURE GRADIENTS
PRESSURE MEASUREMENT
RADIOLOGY AND NUCLEAR MEDICINE
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Recurrence
Sensitivity and Specificity
Stents
Treatment Outcome
Vascular Patency - physiology
VASODILATION
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Summary:To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD +/- SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg. MD +/- SD for repeated measurements at rest and during flow augmentation were 0 +/- 2 mmHg and 1 +/- 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 +/- 7 mmHg at rest and 17 +/- 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions. Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.
ISSN:0174-1551
1432-086X
DOI:10.1007/s002709900187