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British Journal of Radiology (1994) 67, 546-551
© 1994 British Institute of Radiology
doi: 10.1259/0007-1285-67-798-546
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Serial investigation of balloon angioplasty induced changes in the superficial femoral artery using colour duplex ultrasonography

J Henderson, BSc 1 J Chambers, FRACS 2,* T A Jeddy, FRCS 2 J Chamberlain, FRCS 2 and T A Whittingham, BSc, PhD 1

1 Department of Medical Physics, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne, UK 2 Department of Surgery, Freeman Road Hospital, Freeman Road, High Heaton, Newcastle upon Tyne, UK

Percutaneous transluminal balloon angioplasty (PTA) of superficial femoral artery lesions is associated with similar initial success rates in coronary and iliac artery angioplasty but its application is limited by a much higher incidence of restenosis. To improve understanding of the trauma caused to the vessel by balloon angioplasty and the mechanisms contributing to the subsequent processes of healing and restenosis requires serial investigations of the treated arteries in vivo. This paper describes a prospective study using colour duplex ultrasonic imaging to assess arterial changes in 51 patients with atherosclerotic disease undergoing PTA of superficial femoral artery stenoses and occlusions. Each patient was scanned prior to angioplasty and at intervals up to 6 months post-angioplasty. On each scan, measurements were made of the overall vessel and lumen diameters at each site of angioplasty. These measurements indicate that angioplasty improves vessel patency mainly by stretching of the vessel wall, with compression and/or redistribution of the atherosclerotic plaque contributing less than 25% to the improvement of lumen diameter. Serial measurements after angioplasty show complex patterns of change at the angioplasty sites indicating that several mechanisms may be contributing to the processes of vessel healing and subsequent restenosis. Possible mechanisms which could explain the measured changes in overall vessel and lumen diameters are discussed.

* Current address: Department of Vascular Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

Received for publication August 17, 1993. Revision received November 11, 1993. Accepted for publication November 22, 1993.






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