Blood flow in the lower limb after balloon angioplasty of the superficial femoral artery

Abstract

Using duplex ultrasonography lower-limb blood flow measurements were obtained in 20 patients with intermittent claudication. Assessments of flow were made in the common femoral artery, profunda femoris artery (PFA) and superficial femoral artery (SFA) before and after angioplasty for stenoses of short segments of the SFA. Blood flow was measured at rest and after exercise on a cycle ergometer. Collateral flow was calculated using an established mathematical model. Results were compared with the ankle:brachial systolic pressure index (ABPI) after exercise. Although there was no overall increase in resting limb blood flow, an increase in mean (s.d.) SFA flow from 148 (79) to 312 (94) ml min-1, with a concomitant decrease in PFA flow from 224 (84) to 98 (43) ml min-1 was noted 1 week after angioplasty (P < 0.05). At rest there was an increase in mean (s.d.) ABPI from 0.62 (0.12) to 0.89 (0.23) (P < 0.05). Collateral flow was estimated to have decreased from 186 (34) to 18 (8) ml min-1; the pattern of change in flow was similar after exercise. Angioplasty of the SFA remains controversial because of the risk of restenosis. The above methodology allows assessment of whether patients can re-establish collateral flow or whether limb blood flow will be significantly compromised if restenosis occurs.