Rationale and benefits of surveillance after percutaneous transluminal angioplasty and stenting of iliac and femoral arteries

Duplex surveillance of lower extremity bypass grafts significantly improves both primary assisted and secondary patency rates.^1,2 In this setting duplex ultrasound provides objective, hemodynamic data, and can provide detailed anatomic information both in terms of degree of stenosis as well as plaque characteristics and morphology. It can also be cost-effective. ³ The goal of any surveillance protocol is to reduce procedural failures by detecting disease progression within the treated segment and allow for reintervention before a failure is realized. Such a protocol will ideally be cost-effective based on the assumption that the cost of reintervention is less than the cost of treating a failure of that procedure, which is likely to require a more complex intervention with potentially greater morbidity. Although reporting standards are well-established for the surveillance of lower extremity bypass grafts there are currently no such standards for surveillance after lower extremity angioplasty. Therefore, duplex surveillance protocols following angioplasty of the iliac and femoral arteries have largely been based on the concepts and results derived from duplex surveillance of lower extremity bypass grafts.