The Prevalence of Aorto-iliac Disease by Duplex Ultrasound in Patients with Suspected Lower Extremity Arterial Disease

Abstract

Introduction Color duplex ultrasound (CDU) is used to document the location and severity of disease in the arterial system. The purpose of this study was to determine the prevalence, location, and severity of disease in the aorto-iliac arterial segment in patients with signs and symptoms of peripheral arterial disease and undergoing routine lower extremity arterial CDU evaluation. Methods The charts of 45 randomly selected patients with suspected lower extremity peripheral arterial disease (PAD) who were undergoing routine extremity arterial CDU testing were retrospectively reviewed. Disease processes of the aorto-iliac segment were grouped into four categories: ectatic aorta (EA), abdominal aortic aneurysm (AAA), non–hemodynamically significant plaque (NHSP), and hemodynamically significant plaque (HSP). Disease findings were based on internally validated CDU criteria. Findings were considered significant if the patient had AAA or HSP. Results Of the 45 records reviewed, 8 patients did not have an aorto-iliac evaluation based on testing protocols, and 11 were excluded for nonvisualization of the aorto-iliac segment due to bowel gas or body habitus. Of the 26 remaining patients, 4 patients presented with normal findings (15%), 14 with NHSP (54%), 8 with AAA (31%), 7 with HSP (27%), and 2 with EC of the aorta (8%). When grouped by significant findings, 4 patients presented with AAA and HSP (15%), 4 with AAA only (15%), and 3 with HSP (12%). Conclusion Findings of disease in the aorto-iliac segment were noted in 85% of the patients in this population. Significant disease was present in 42% of the patients in this population. Evaluation of the aorto-iliac segment with CDU in patients with suspected PAD appears to have a significant yield; however, further investigation with a larger patient population and a comparison to other testing modalities is necessary.