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KMID : 1147320160030020053
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Journal of Surgical Ultrasound
2016 Volume.3 No. 2 p.53 ~ p.59
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Duplex Protocol to Avoid the Vascular Complications before the Anterior Lumbar Interbody Fusion Surgery
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Eo Yoon-Sun
Joh Jin-Hyun
Park Ho-Chul
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Abstract
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Purpose: Anterior exposure has become increasingly popular for the management of lumbar degenerative diseases. Arterial thrombosis or embolization can be a dangerous complication with this approach; however, preoperative assessment of arterial pathology can help reduce it. This study was conducted to investigate the duplex protocol and its usefulness to evaluate the vascular pathology before application of the anterior approach.
Methods: Patients who were referred to the vascular laboratory consecutively from January 2015 to February 2016, were included in the study. All patients underwent standardized duplex ultrasonography (DUS), including measurement of the ankle-brachial index (ABI) and evaluation of the arterial pathology. The pathology of the aorta and iliac arteries was characterized using the findings of duplex scanning.
Results: This study included 99 patients with a mean age of 70.4 ± 7.6 years (range, 49-86 years). We detected the arterial pathology in 29 (29.3%) patients: calcified plaques on aorta or iliac artery in 21 (72.4%) patients, calcified plaques on the tibial artery in six (20.7%) patients, unilateral iliac artery occlusion in one (3.4%) patient, and abdominal aortic aneurysm in one (3.4%) patient. The last two patients were referred to the vascular surgery for definite treatment of vascular problem. Abnormal ABI (<0.9) was detected in four limbs of three patients.
Conclusion: Preoperative assessment with DUS was a simple and useful strategy to evaluate the vascular pathology surrounding the operative fields before anterior approach. One-third of patients had a vascular problem in this study. Further study is needed to analyze its benefits and cost-effectiveness.
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KEYWORD
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Ultrasonography, Anterior approach, Interbody fusion, Aneurysm, Atherosclerosis
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