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Duplex
ultrasound has long been used for imaging of peripheral vessels, particularly of
the venous system. Duplex studies rely on Doppler ultrasound and provide
information about vessel size as well as blood flow. Duplex ultrasound is
non-invasive and is capable of detecting flow with vessel resolution to 1 mm.
19 Duplex imaging is commonly used by peripheral vascular surgeons to
obtain information about vessel anatomy and flow prior to obtaining arteriograms.
Duplex studies are also commonly used to assess the competence of the lower
extremity venous systems and for vein mapping.
There have been
several recent reports which have described the use of duplex imaging prior to
perforator flap harvest to identify and map perforators particularly for deep
inferior Epigastric perforator flaps. 20 In addition, color duppler
stuidies have been used as a “less invasive” alternative to angiography prior to
fibula harvest. 19 Duplex studies have also been used for
post-operative flap monitoring particularly for buried flaps such as jejunal
transfers. 21 However, while the examination can provide information
about vessel patency, it merely provides a static evaluation rather than a
continuous information.
Duplex ultrasound is
the least invasive and typically least expensive imaging modality, however it
typically provides the least detailed information. While Doppler studies can
provide important information about vessel flow they do not provide precise
information regarding vessel calcification and do not provide a road map which
can be utilized in the operating room. Another drawback of Duplex studies is
that they are often technician dependent. For microsurgical reconstruction
ultrasound may have its best application in evaluation of the lower extremity
venous system.
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