Interobserver variation of colour duplex scanning of the popliteal,tibial and pedal arteries
Related Experiment Video
Updated: Oct 9, 2026

Dual-mode Imaging of Cutaneous Tissue Oxygenation and Vascular Function
Published on: December 8, 2010
M J Koelemay1, D A Legemate, J A van Gurp
1Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Objectives:
to determine interobserver variation in the measurement of Peak Systolic Velocity (PSV) and grading of disease by means of Duplex scanning (DS) in the popliteal, tibial and pedal arteries.
Design:
prospective validation study.
Materials:
twenty-four consecutive patients with severe claudication (n=6), ischaemic rest pain (n=11) and tissue loss (n=7).
Methods:
two vascular technologists independently examined the popliteal, tibial and pedal arteries. The PSV was recorded in 15 arterial segments that were graded with B-mode and Doppler parameters as fully patent, severely diseased or occluded. Concordance in PSV recordings was expressed as intraclass correlation coefficients (ICC). Agreement in artery assessment was expressed as weighted kappa-values.
Results:
the ICC for PSV measurements was 0.90 (95% CI, 0.86 to 0.93) within the popliteal and tibial arteries and 0.64 (95% CI, 0.37 to 0.81) within the pedal arteries. Agreement for grading disease was good within the popliteal and tibial arteries (kappa 0.66, 95% CI, 0.58 to 0.74), and moderate within the pedal arteries (kappa 0.54, 95% CI 0.33 to 0.74). The presence of diabetes or stage of disease did not influence interobserver agreement.
Conclusion:
interobserver agreement of DS is good within the popliteal and tibial arteries and moderate within the pedal arteries.
More Related Videos
Related Concept Videos
Pulse Assessment Sites
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Arteries of Lower Limbs
Assessing Blood pressure in the Leg
Preparation:
Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above the...

