Prospective Study on Diagnostic Performance of Color Doppler Ultrasound Using Trans-stenotic Mean Arterial Pressure Gradient as a Reference in Stented Superior Mesenteric Artery

Background: The aim of this study was to evaluate the diagnostic performance of color Doppler ultrasound (CDU) after stenting of superior mesenteric artery (SMA) stenosis using mean arterial pressure (MAP) gradients as a reference method. Methods: This is a prospective study. Thirty-one patients underwent 51 paired measurements of MAP gradients and CDU after endovascular intervention with endoprosthesis in the SMA for mesenteric atherosclerotic disease between March 2009 and July 2016. Results: Peak systolic velocities (PSVs; r = 0.44, P = 0.001) and end-diastolic velocities (EDVs; r = 0.59, P < 0.001) correlated with MAP gradients. The area under the receiver-operating characteristics curve for diagnosis of significant in-stent stenosis for different threshold values of PSV and EDV using MAP gradient of ≥10 mm Hg as reference was 0.75 and 0.80, respectively. Sensitivity and specificity for PSV >3.3 m/s were 43.5% (95% confidence interval [CI] 23.2–63.7) and 92.9% (95% CI 83.3–100.0), respectively. Sensitivity and specificity for EDV >0.50 m/s were 63.6% (95% CI 43.5–83.7) and 92.3% (95% CI 82.1–100.0), respectively. Specificity and positive predictive value were both 100% for combined PSV >3.0 m/s and EDV >0.5 m/s. Conclusions: PSV and EDV were equally useful in evaluation of significant SMA stent stenosis, when using trans-stenotic MAP gradient as reference. Finding of a significant stenosis on CDU should be considered as a true significant SMA stent stenosis.