Color flow doppler ultrasonography: Comparison with peripheral arteriography for the investigation of peripheral vascular disease

Abstract

Using arteriography as the gold standard, Color flow Doppler ultrasonography was evaluated with regard to its ability to detect peripheral vascular occlusive disease and hemodynamically significant stenosis in patients having peripheral arteriography. One hundred legs in 51 patients were compared at seven arterial segments for disease. Color flow Doppler ultrasonography correctly detected 84 occluded segments, and demonstrated a sensitivity and specificity for patency vs occlusive disease of 95% and 99%, respectively. One hundred and thirty hemodynamically significant lesions (occlusions plus significant stenosis) were correctly identified with color flow Doppler ultrasonography, with a sensitivity and specificity of 92% and 97%, respectively. Color flow Doppler ultrasonography is a safe, inexpensive, and noninvasive method of accurately documenting significant peripheral arterial disease and offers a new first-line investigation for patients presenting with symptoms of peripheral arterial insufficiency.

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

“…For patients who do not develop specific limb or cardiovascular symptoms, exercise may be terminated when patients achieve a high functional peak systolic velocity ratios have been found to be the most accurate diagnostic criterion. A ratio greater than 2 is commonly used to diagnose a stenosis greater than 50% diameter (201,202,205,207), although other ratios have been used (203,204,206,210). Some studies have attempted to further calibrate the duplex technique to distinguish between degrees of stenosis between 50% and 75% versus 75% and 99% (203,204,207,210).…”

Peripheral Artery Disease: Current Insight Into the Disease and Its Diagnosis and Management

“…60 Duplex ultrasonography is an accurate method for determining the degree of stenosis or length of occlusion of the arteries supplying the lower extremity. [61][62][63] Furthermore, duplex ultrasonography may be useful in the follow-up of patients who have undergone endovascular (percutaneous transluminal angioplasty/stent) or surgical revascularization. Some clinicians routinely place their patients into an ultrasound surveillance program after angioplasty or stent implantation, and most surgeons do so after lower-extremity bypass surgery.…”

Peripheral Arterial Disease—What Do We Need to Know?

“…Color flow Doppler and pulsed wave Doppler allow one to estimate stenosis severity based on Doppler derived velocity criteria. 10 It can also be used for surveillance of patients following revascularization procedures to identify reocclusion. Although DU is an accurate test for PAD, it requires a high degree of technical expertise as well as expensive equipment that may be lacking in some centers.…”