Comparative evaluation of color Doppler and conventional digital subtraction angiography in arterial disease

Abstract

Introduction: Peripheral Arterial Occlusive Disease (PAOD) leads to narrowing and hardening of arteries which leads to increased risk of lower extremity amputation. Hence, the accuracy of non-invasive diagnostic methods such as Color Doppler (CD) needs to be assessed in comparison to the conventional digital subtraction angiography (CDSA). Objective: To compare color Doppler and conventional digital subtraction arteriography in patients of infragenicular arterial disease. To evaluate and correlate the findings of CD with arteriography as the gold standard, in PAOD of the lower extremities in supra-genicular part and to define whether color Doppler, is an alternative or an adjunct to DSA. Methods: In this study 60 patients suspected of lower limb PAD aged between 40 and 70 years were included. All these patients with symptoms suggestive of PAOD underwent color Doppler study of lower limb arterial system. Afterward, 55 patients of PAOD formed the subjects and their affected lower limbs evaluated by CD and arteriography, for localization and grading of lesion in the arteries, into normal/insignificant stenosis and occlusion. The sensitivity, specificity, and positive and negative predictive values of CD as compared to CDSA in arterial disease were calculated. Results were analyzed by two way contingency tables, using calculator, and SSP software. Results: As compared to conventional digital subtraction angiography, Doppler assessment was more sensitive specific with greater diagnostic accuracy. Conclusion: CD is better than conventional digital subtraction angiography in diagnosis of Grade 1 &2 cases, with better assessment of soft plaques, segmental flow and recanalization in PAD and CD performed well compared with conventional digital subtraction angiography. Hence color Doppler can be an alternative to conventional digital subtraction angiography in diagnosing peripheral arterial occlusive diseases in supragenicular part of lower limb arteries.