Abstract

Purpose: To assess the efficacy of color Doppler imaging for decision making in the treatment of patients with lower extremity peripheral arterial disease (PAD) compared to digital subtraction angiography (DSA). Materials and Methods: Color Doppler scan was done on patients suspected for lower limb PAD, a day prior to the DSA which was done by a vascular surgeon. Also, for the patients who were candidates for endovascular intervention based on the color Doppler arterial mapping results, endovascular interventions were performed at the same time if the DSA findings are correlated with the color Doppler map. The grading for evaluated segments was normal, insignificant stenosis (Results: Totally 115 lower extremities (2045 arterial segments) were evaluated in 90 patients [mean age: 60.8 ± 8.9 (range: 47 - 84 years old)] of which 68 (75.6%) were men. The sensitivity of color Doppler for all arterial segments was 90% or higher except for common iliac artery, distal segment of superficial femoral artery and proximal segments of anterior and posterior tibialis and peroneal arteries. However, the specificity was 89% or higher, in all arterial segments. Kappa agreement was 0.72 or higher in all segments (All P-Values 0.001). Conclusion: This study suggests that considering excellent capability of color Doppler sonography in the evaluation of lower extremity arterial disease, color Doppler arterial mapping is sufficient for decision making in the treatment of these patients and can reduce the rate of diagnostic angiography.

Highlights

  • Peripheral arterial disease (PAD) is a common problem in the elderly, especially among diabetic patients

  • To assess the efficacy of color Doppler imaging for decision making in the treatment of patients with lower extremity peripheral arterial disease (PAD) compared to digital subtraction angiography (DSA)

  • For the patients who were candidates for endovascular intervention based on the color Doppler arterial mapping results, endovascular interventions were performed at the same time if the DSA findings are correlated with the color Doppler map

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Summary

Introduction

Peripheral arterial disease (PAD) is a common problem in the elderly, especially among diabetic patients. Digital subtraction angiography (DSA) provides visualized images of arterial tree. It can be used for endovascular interventions. Recent studies indicate that the sensitivity and specificity of an arterial duplex study and color flow imaging have increased significantly, making it a highly effective modality for non-invasive evaluation of PAD [7]. It has shown that color Doppler sonography is useful in planning treatment in patients with PAD [13,14]. Our aim in this study was to determine whether the color Doppler arterial mapping would be useful in treatment planning in patients with lower extremity peripheral arterial disease (PAD) by providing an image of the arterial tree for the clinician

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