Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries

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Abstract

Objectives: Superior mesenteric artery (SMA) duplex scanning is utilized to screen for high-grade (≥70%) SMA stenosis (peak systolic velocity [PSV] ≥275 cm/second) and for follow-up of SMA bypass grafts and stents. Expected duplex scan findings in SMA bypass grafts have been recently reported. There is, however, little information correlating duplex scans from stented SMAs to procedural angiograms in patients treated for high-grade (≥70%) SMA stenosis. We report validation of duplex scan criteria for high-grade native artery SMA stenosis, and also duplex scan examined results after SMA stent placement correlated with angiograms and angiographic measured pressure gradients pre- and post-SMA stent placement. Methods and Results: Thirty-five patients with symptoms consistent with mesenteric ischemia were treated with SMA stents. Pre-intervention angiography demonstrated >70% SMA stenosis or SMA occlusion in all but 3 patients. Pre-intervention pressure gradients were obtained in 20 stenotic but patent SMAs and averaged 57 ± 38 mm Hg; range, 15 to 187 mm Hg. Eighteen of the patients had SMA duplex scan prior to angiography, and 17 demonstrated an SMA PSV ≥275 cm/second or no flow, (mean 450 ± 152 cm/second in patent arteries; range, 256 to 770 cm/second). Post-stent placement angiography demonstrated

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalJournal of Vascular Surgery
Volume50
Issue number2
DOIs
StatePublished - Aug 2009

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Superior Mesenteric Artery
Pathologic Constriction
Stents
Angiography
Arteries
Transplants
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

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title = "Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries",
abstract = "Objectives: Superior mesenteric artery (SMA) duplex scanning is utilized to screen for high-grade (≥70{\%}) SMA stenosis (peak systolic velocity [PSV] ≥275 cm/second) and for follow-up of SMA bypass grafts and stents. Expected duplex scan findings in SMA bypass grafts have been recently reported. There is, however, little information correlating duplex scans from stented SMAs to procedural angiograms in patients treated for high-grade (≥70{\%}) SMA stenosis. We report validation of duplex scan criteria for high-grade native artery SMA stenosis, and also duplex scan examined results after SMA stent placement correlated with angiograms and angiographic measured pressure gradients pre- and post-SMA stent placement. Methods and Results: Thirty-five patients with symptoms consistent with mesenteric ischemia were treated with SMA stents. Pre-intervention angiography demonstrated >70{\%} SMA stenosis or SMA occlusion in all but 3 patients. Pre-intervention pressure gradients were obtained in 20 stenotic but patent SMAs and averaged 57 ± 38 mm Hg; range, 15 to 187 mm Hg. Eighteen of the patients had SMA duplex scan prior to angiography, and 17 demonstrated an SMA PSV ≥275 cm/second or no flow, (mean 450 ± 152 cm/second in patent arteries; range, 256 to 770 cm/second). Post-stent placement angiography demonstrated",
author = "Erica Mitchell and Chang, {Eugene Y.} and Gregory Landry and Timothy Liem and Frederick Keller and Moneta, {Gregory (Greg)}",
year = "2009",
month = "8",
doi = "10.1016/j.jvs.2008.12.071",
language = "English (US)",
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T1 - Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries

AU - Mitchell, Erica

AU - Chang, Eugene Y.

AU - Landry, Gregory

AU - Liem, Timothy

AU - Keller, Frederick

AU - Moneta, Gregory (Greg)

PY - 2009/8

Y1 - 2009/8

N2 - Objectives: Superior mesenteric artery (SMA) duplex scanning is utilized to screen for high-grade (≥70%) SMA stenosis (peak systolic velocity [PSV] ≥275 cm/second) and for follow-up of SMA bypass grafts and stents. Expected duplex scan findings in SMA bypass grafts have been recently reported. There is, however, little information correlating duplex scans from stented SMAs to procedural angiograms in patients treated for high-grade (≥70%) SMA stenosis. We report validation of duplex scan criteria for high-grade native artery SMA stenosis, and also duplex scan examined results after SMA stent placement correlated with angiograms and angiographic measured pressure gradients pre- and post-SMA stent placement. Methods and Results: Thirty-five patients with symptoms consistent with mesenteric ischemia were treated with SMA stents. Pre-intervention angiography demonstrated >70% SMA stenosis or SMA occlusion in all but 3 patients. Pre-intervention pressure gradients were obtained in 20 stenotic but patent SMAs and averaged 57 ± 38 mm Hg; range, 15 to 187 mm Hg. Eighteen of the patients had SMA duplex scan prior to angiography, and 17 demonstrated an SMA PSV ≥275 cm/second or no flow, (mean 450 ± 152 cm/second in patent arteries; range, 256 to 770 cm/second). Post-stent placement angiography demonstrated

AB - Objectives: Superior mesenteric artery (SMA) duplex scanning is utilized to screen for high-grade (≥70%) SMA stenosis (peak systolic velocity [PSV] ≥275 cm/second) and for follow-up of SMA bypass grafts and stents. Expected duplex scan findings in SMA bypass grafts have been recently reported. There is, however, little information correlating duplex scans from stented SMAs to procedural angiograms in patients treated for high-grade (≥70%) SMA stenosis. We report validation of duplex scan criteria for high-grade native artery SMA stenosis, and also duplex scan examined results after SMA stent placement correlated with angiograms and angiographic measured pressure gradients pre- and post-SMA stent placement. Methods and Results: Thirty-five patients with symptoms consistent with mesenteric ischemia were treated with SMA stents. Pre-intervention angiography demonstrated >70% SMA stenosis or SMA occlusion in all but 3 patients. Pre-intervention pressure gradients were obtained in 20 stenotic but patent SMAs and averaged 57 ± 38 mm Hg; range, 15 to 187 mm Hg. Eighteen of the patients had SMA duplex scan prior to angiography, and 17 demonstrated an SMA PSV ≥275 cm/second or no flow, (mean 450 ± 152 cm/second in patent arteries; range, 256 to 770 cm/second). Post-stent placement angiography demonstrated

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