title: Role of ultrasound arterial mapping in planning therapeutic options for critical ischemia of lower limbs in diabetic patients.
abstract: BACKGROUND
  To assess the role of ultrasound arterial mapping in planning therapeutic options for critical limb ischemia (CLI) in diabetic patients.
  
  
  METHODS
  This observational and comparative study included 244 patients with CLI. All participants (64% were diabetic) underwent ultrasound arterial mapping before planning surgical treatment. We established two groups: diabetic (n = 156) and nondiabetic (n = 88). Arterial mapping was divided into segments. We studied 2,021 individual segments and used arteriography when ultrasound arterial mapping was not conclusive. We compared the degree of pathology between the groups, agreement between the treatment decision made after ultrasound mapping and the final surgical decision in both groups, and agreement between ultrasound mapping and arteriography in patients who underwent both procedures.
  
  
  RESULTS
  Diabetic patients had a significantly higher degree of pathology in all segments, except the common iliac artery. Decisions made after ultrasound mapping matched the final surgical decision 90% and 94% of the time in diabetic patients and nondiabetic patients, respectively. Decisions made on the basis of ultrasound arterial mapping matched decisions made on the basis of arteriography in 86.3%.
  
  
  CONCLUSIONS
  Ultrasound arterial mapping allowed for good therapeutic planning for CLI in diabetic patients, even though these patients had more severe arterial pathology.
authors: Vascular Surgery Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. xamame@hotmail.com
authors: Xavier
authors: X
authors: Martí
authors: Antoni
authors: A
authors: Romera
authors: Ramon
authors: R
authors: Vila
authors: Marc A
authors: MA
authors: Cairols
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016638:Critical Illness; D003661:Decision Support Techniques; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011859:Radiography; D012720:Severity of Illness Index; D025321:Surgery, Computer-Assisted; D018617:Ultrasonography, Doppler, Pulsed; D014656:Vascular Surgical Procedures