Management of peripheral arterial disease with the use of a duplex guide (limb salvage) in a hospital of third level in Bogotá (Colombia)

Abstract

Introduction: peripheral arterial disease (PAD) is considered an underdiagnosed pathology that affects nearly 200 million people and is associated with a high burden of morbidity and mortality. In many cases, endovascular management is preferred over open surgery, especially in patients with multiple comorbidities that limit the latter approach. However, it has limitations related to the use of contrast medium in the context of patients who addi-tionally have multiple comorbidities, including kidney disease, which can compromise their underlying pathology. Therefore, the need arises to implement a method that limits the use of contrast, without compromising the technical success of the procedure. Materials and methods: a retrospective analysis of those patients who received endovascular treatment under ultrasonography guidance for the treatment of acute limb ischemia and their postoperative outcome. Objective: describe the characteristics of the arterial lesions, the post-surgical results and the complications of the patients who received management of arterial occlusive disease with extremity threat by endovascular approach under ultrasonographic guidance, at the University Hospital La Samaritana (Bogota, Colombia) between 2018 -2022. Results: a total of 40 patients were identified with 3 types of lesions including stenosis, and mixed lesions. Those patients received either balloon angioplasty, angioplasty with stent or thrombectomies. The main associated com-plication was pseudoaneurysm after arterial catheter removal in 22.5 %, followed by arterial dissection in 13 %. Post-surgical success was considered in 92.7 % of patients, evidenced either on the improvement in the percentage of final peak systolic velocity or in the morphology of the artery distal to the intervened segment. Conclusion:The use of ultrasonography as a guide for endovascular procedures is presented as an alternative to conventional angiography, with good success rates.