Lower Extremity Arterial Mapping: Duplex Ultrasound as an Alternative to Arteriography Prior to Femoral and Popliteal Reconstruction

Abstract

The clinical experience with periprocedural duplex ultrasound detailed in this chapter is based on over 2,000 lower extremity open and endovascular arterial revascularization procedures. The topics discussed include goals of testing, detailed protocols of duplex ultrasound arterial mapping (DUAM), rationale of preoperative DUAM for revascularization decision making, and comparison of DUAM with other imaging modalities such as contrast arteriography (XRA), magnetic resonance angiography (MRA), and computed tomography arteriography (CTA). The limitations and pitfalls of duplex arterial testing are discussed as well as the learning curve for this diagnostic technique including necessary components to be followed during the training phase for replacing other imaging modalities with DUAM.