Occlusive Lower-extremity arterial disease: clinical setting and diagnostic imaging

Abstract

Background: The clinical diagnosis of occlusive lower extremity arterial disease (OLEAD is usually clear but certain investigations are needed to confirm the diagnosis and determine extent and severity of the disease for treatment plans. A diagnosis of OLEAD mandates a comprehensive approach involving justification of the clinical features and imaging facilities. Objectives To assess diagnostic accuracy of occlusive lower extremity arterial disease that was based on clinical approach and to compare vascular imaging in Doppler Duplex with CT 64-Multislice Detector Angi. ography. Materials and methods. The study included 53 patients who were admitted in the surgical ward for evaluation and treatment of lower extremity arterial disease from January 2009 through June 2009. Clinical assessment, Doppler Duplex and CT angiography was performed for all patients. Doppler Duplex reports and CT images were compared to determine the extent of the occlusive process. ResultsThere were 41 male and 12 female patients. Pre Imaging clinical diagnosis was determined in all patients. Doppler Duplex was a useful diagnosis of femoropopliteal disease but not in aortoiliac disease. CT angiography was helpful in the diagnosis of aortoiliac disease. It was also helpful in determining the extent of femoropopliteal disease and assessment of collateral circulation. Conclusion: A combination of clinical assessment, Doppler Duplex and CT angiography is necessary for perfect diagnosis and planning of treatment. Doppler Duplex in expert hands is a useful modality for estimation of a diseased segment in the infrainguinal region but not for aorta iliac arteries.