Experimental, comparative, duplex mapping study of arterial flow distribution in ischemia and reperfusion by retrograde circulation

Treatment options for critical lower limb ischemia in the absence of the distal bed are limited. Diverting blood flow in a retrograde direction through the venous circulation is one alternative option that is supported by evidence from several published articles. Duplex scanning was used to compare the distribution of arterial flow in hind limbs of pigs maintained in physiological circulation to contralateral limbs subjected to ischemia and reperfusion by retrograde circulation. Flow in limbs with physiological and retrograde circulation was evaluated by duplex scanning with analysis of Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV), and the Resistivity Index (RI) for selected arteries. This comparative analysis of extremities maintained in physiological circulation in relation to those subjected to ischemia and reperfusion by retrograde circulation showed, via duplex scanning, that changes in spectral wave patterns and hemodynamic variables are satisfactory indicators and suggest good distribution of distal blood flow.