title: The role of duplex scanning in the diagnosis of lower limb arterial disease.
abstract: Color flow duplex imaging of the iliac and femoropopliteal arteries was performed in patients undergoing angiography. The aim of the study was to determine: (1) in what percentage of patients could the iliac arteries be adequately visualized to enable a diagnosis, (2) the overall accuracy of duplex scanning in the diagnosis of arterial disease, and (3) whether there is a useful duplex criterion for the selection of patients for angioplasty. One hundred and twenty patients (79 males, 41 females; mean age 64.4 years) had duplex scans prior to angiography (2-7 days) and the results were compared. The duplex criteria of an increase in the peak systolic velocity ratio (PSVR) >2 and lesions <5 cm were used to signify hemodynamically significant stenosis (>50% narrowing), the presence of plaque and calcification in the arterial wall with alteration of PSVR and lesions >5 cm, diffuse disease, and the absence of flow on color/Doppler interrogation, occlusion. The results show that duplex scanning is a useful screening tool and may be effectively used to diagnose iliac and femoropopliteal disease in nearly 80% of patients. Angiography will be needed in those in whom duplex scanning is inconclusive, or, prior to intervention in those with disease suitable for surgical reconstruction or angioplasty, diagnosed on the basis of duplex scans.
authors.affiliation: Irvine laboratory for Cardiovascular Research, Academic Surgical Unit, Imperial College School of Medicine at St. Mary's Hospital, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Ramaswami
authors.forename: A
authors.initials: A
authors.lastname: Al-Kutoubi
authors.forename: A N
authors.initials: AN
authors.lastname: Nicolaides
authors.forename: S
authors.initials: S
authors.lastname: Dhanjil
authors.forename: M
authors.initials: M
authors.lastname: Griffin
authors.forename: G
authors.initials: G
authors.lastname: Belcaro
authors.forename: L D
authors.initials: LD
authors.lastname: Coen
mesh_terms: D000792:Angiography; D015901:Angiography, Digital Subtraction; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D002114:Calcinosis / Q000000981:diagnostic imaging; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007866:Leg / Q000098:blood supply*; D008875:Middle Aged; D018579:Patient Selection; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013599:Systole; D016909:Tibial Arteries / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex