Whyman, Mark Roy; (1992) Measurement and monitoring of atheromatous lesions of the femoral artery by duplex ultrasound. Doctoral thesis (M.S.), University College London.

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Abstract

In Western Societies atheromatous stenosis and occlusion of the superficial femoral artery cause intermittent claudication in up to 5% of the population over 55 years of age, and the associated morbidity and disability are considerable. A foreknowledge of impending lesion progression might allow prevention of clinical deterioration by early intervention. However, the natural history of these lesions needs to be more fully evaluated. Critical to the monitoring of early lesions is the need for accurate, repeatable and non-invasive investigations. The role of duplex ultrasound in this area is largely unexplored. In this thesis clinical and laboratory data demonstrate the accuracy and repeatability of duplex ultrasound in the measurement of femoral stenoses. A prospective study was carried out to determine the incidence of progression from stenosis to occlusion. There has been an enormous increase in the use of percutaneous transluminal angioplasty (PTA) in the treatment of patients with claudication. However, the relative benefits of PTA over conventional treatment have not been established. A study to determine the role of duplex in screening patients with claudication prior to PTA was carried out. The results demonstrate its accuracy and the consequent clinical benefits. A randomised controlled trial of PTA for patients with intermittent claudication has been established and the early patient data at trial entry are presented.

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