Duplex ultrasound scanning of peripheral arterial disease of the lower limb

Jonas Peter Eiberg; John Bøje Grønvall Rasmussen; Marc Allan Hansen; Torben Veith Schroeder

doi:http://dx.doi.org/10.1016/j.ejvs.2010.06.002

Duplex ultrasound scanning of peripheral arterial disease of the lower limb

Jonas Peter Eiberg, John Bøje Grønvall Rasmussen, Marc Allan Hansen, Torben Veith Schroeder

56 Citations (Scopus)

Abstract

Objectives: To assess the reliability and applicability of duplex ultrasound scanning (DUS) of lower limb arteries, compared with digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD). Design: A prospective, blinded, comparative study. Materials and methods: A total of 169 patients were examined by DUS and DSA. Intermittent claudication (IC) was present in 42 (25%) patients and critical limb ischaemia (CLI) in 127 (75%) patients. To allow segment-to-segment comparison, the arterial tree was divided into 15 segments. In total, 2535 segments were examined using kappa (k) statistics to test the agreement. Results: The agreement between DUS and DSA was very good (k > 0.8) or good (0.8 ≥ k > 0.6) in most segments, but moderate (0.6 ≥ k > 0.4) in the tibio-peroneal trunk and the peroneal artery. Agreement between the two techniques was significantly better in the supragenicular (kZ0.75 (95% confidence interval (CI): 0.70-0.80)) than in the infragenicular segments (kZ0.63 (0.59e0.67)) (p < 0.001). Similarly, the technical success rate was significantly higher in the supragenicular segments (DUS: 100%; DSA: 99%) than in the infragenicular segments (both 93%) (p < 0.001). DUS was the best technique for imaging of the distal crural arteries (92% vs. 97%; p < 0.001) and DSA was the best technique for imaging of the proximal crural arteries (95% vs. 91%; p < 0.01). Neither the agreement nor the technical success rate was influenced by the severity of PAD, that is, IC versus CLI. Conclusion: The agreement between DUS and DSA was generally good, irrespective of the severity of ischaemia. DUS performed better in the supragenicular arteries than in the infragenicular arteries. However, DUS compared favourably with DSA in both tibial vessels, particularly in the distal part, which makes DUS a useful non-invasive alternative to DSA.

Original language	English
Journal	European Journal of Vascular and Endovascular Surgery
Volume	40
Issue number	4
Pages (from-to)	507-12
Number of pages	6
ISSN	1078-5884
DOIs	https://doi.org/10.1016/j.ejvs.2010.06.002
Publication status	Published - 1 Oct 2010

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title = "Duplex ultrasound scanning of peripheral arterial disease of the lower limb",

abstract = "Objectives: To assess the reliability and applicability of duplex ultrasound scanning (DUS) of lower limb arteries, compared with digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD). Design: A prospective, blinded, comparative study. Materials and methods: A total of 169 patients were examined by DUS and DSA. Intermittent claudication (IC) was present in 42 (25%) patients and critical limb ischaemia (CLI) in 127 (75%) patients. To allow segment-to-segment comparison, the arterial tree was divided into 15 segments. In total, 2535 segments were examined using kappa (k) statistics to test the agreement. Results: The agreement between DUS and DSA was very good (k > 0.8) or good (0.8 ≥ k > 0.6) in most segments, but moderate (0.6 ≥ k > 0.4) in the tibio-peroneal trunk and the peroneal artery. Agreement between the two techniques was significantly better in the supragenicular (kZ0.75 (95% confidence interval (CI): 0.70-0.80)) than in the infragenicular segments (kZ0.63 (0.59e0.67)) (p < 0.001). Similarly, the technical success rate was significantly higher in the supragenicular segments (DUS: 100%; DSA: 99%) than in the infragenicular segments (both 93%) (p < 0.001). DUS was the best technique for imaging of the distal crural arteries (92% vs. 97%; p < 0.001) and DSA was the best technique for imaging of the proximal crural arteries (95% vs. 91%; p < 0.01). Neither the agreement nor the technical success rate was influenced by the severity of PAD, that is, IC versus CLI. Conclusion: The agreement between DUS and DSA was generally good, irrespective of the severity of ischaemia. DUS performed better in the supragenicular arteries than in the infragenicular arteries. However, DUS compared favourably with DSA in both tibial vessels, particularly in the distal part, which makes DUS a useful non-invasive alternative to DSA.",

author = "Eiberg, {Jonas Peter} and Rasmussen, {John B{\o}je Gr{\o}nvall} and Hansen, {Marc Allan} and Schroeder, {Torben Veith}",

year = "2010",

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doi = "http://dx.doi.org/10.1016/j.ejvs.2010.06.002",

language = "English",

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journal = "European Journal of Vascular and Endovascular Surgery",

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T1 - Duplex ultrasound scanning of peripheral arterial disease of the lower limb

AU - Eiberg, Jonas Peter

AU - Rasmussen, John Bøje Grønvall

AU - Hansen, Marc Allan

AU - Schroeder, Torben Veith

PY - 2010/10/1

Y1 - 2010/10/1

N2 - Objectives: To assess the reliability and applicability of duplex ultrasound scanning (DUS) of lower limb arteries, compared with digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD). Design: A prospective, blinded, comparative study. Materials and methods: A total of 169 patients were examined by DUS and DSA. Intermittent claudication (IC) was present in 42 (25%) patients and critical limb ischaemia (CLI) in 127 (75%) patients. To allow segment-to-segment comparison, the arterial tree was divided into 15 segments. In total, 2535 segments were examined using kappa (k) statistics to test the agreement. Results: The agreement between DUS and DSA was very good (k > 0.8) or good (0.8 ≥ k > 0.6) in most segments, but moderate (0.6 ≥ k > 0.4) in the tibio-peroneal trunk and the peroneal artery. Agreement between the two techniques was significantly better in the supragenicular (kZ0.75 (95% confidence interval (CI): 0.70-0.80)) than in the infragenicular segments (kZ0.63 (0.59e0.67)) (p < 0.001). Similarly, the technical success rate was significantly higher in the supragenicular segments (DUS: 100%; DSA: 99%) than in the infragenicular segments (both 93%) (p < 0.001). DUS was the best technique for imaging of the distal crural arteries (92% vs. 97%; p < 0.001) and DSA was the best technique for imaging of the proximal crural arteries (95% vs. 91%; p < 0.01). Neither the agreement nor the technical success rate was influenced by the severity of PAD, that is, IC versus CLI. Conclusion: The agreement between DUS and DSA was generally good, irrespective of the severity of ischaemia. DUS performed better in the supragenicular arteries than in the infragenicular arteries. However, DUS compared favourably with DSA in both tibial vessels, particularly in the distal part, which makes DUS a useful non-invasive alternative to DSA.

AB - Objectives: To assess the reliability and applicability of duplex ultrasound scanning (DUS) of lower limb arteries, compared with digital subtraction angiography (DSA), in patients with peripheral arterial disease (PAD). Design: A prospective, blinded, comparative study. Materials and methods: A total of 169 patients were examined by DUS and DSA. Intermittent claudication (IC) was present in 42 (25%) patients and critical limb ischaemia (CLI) in 127 (75%) patients. To allow segment-to-segment comparison, the arterial tree was divided into 15 segments. In total, 2535 segments were examined using kappa (k) statistics to test the agreement. Results: The agreement between DUS and DSA was very good (k > 0.8) or good (0.8 ≥ k > 0.6) in most segments, but moderate (0.6 ≥ k > 0.4) in the tibio-peroneal trunk and the peroneal artery. Agreement between the two techniques was significantly better in the supragenicular (kZ0.75 (95% confidence interval (CI): 0.70-0.80)) than in the infragenicular segments (kZ0.63 (0.59e0.67)) (p < 0.001). Similarly, the technical success rate was significantly higher in the supragenicular segments (DUS: 100%; DSA: 99%) than in the infragenicular segments (both 93%) (p < 0.001). DUS was the best technique for imaging of the distal crural arteries (92% vs. 97%; p < 0.001) and DSA was the best technique for imaging of the proximal crural arteries (95% vs. 91%; p < 0.01). Neither the agreement nor the technical success rate was influenced by the severity of PAD, that is, IC versus CLI. Conclusion: The agreement between DUS and DSA was generally good, irrespective of the severity of ischaemia. DUS performed better in the supragenicular arteries than in the infragenicular arteries. However, DUS compared favourably with DSA in both tibial vessels, particularly in the distal part, which makes DUS a useful non-invasive alternative to DSA.

U2 - http://dx.doi.org/10.1016/j.ejvs.2010.06.002

DO - http://dx.doi.org/10.1016/j.ejvs.2010.06.002

M3 - Journal article

SN - 1078-5884

VL - 40

SP - 507

EP - 512

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

IS - 4

ER -

Duplex ultrasound scanning of peripheral arterial disease of the lower limb

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