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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis

Published on: February 10, 2023

Ischemic disease of lower extremities--risk factors and ultrasound diagnostic

S Bodikova1, L Flak

  • 1IVth Department of Internal Medicine, Comenius University, Bratislava, Slovakia. bodikova@post.sk

Bratislavske Lekarske Listy
|August 10, 2007
PubMed

Insights

This study on peripheral arterial occlusive disease (PAOD) found atherosclerosis commonly affects both carotid and leg arteries. Duplex sonography is highly accurate for femoro-popliteal disease but less so for infrapopliteal disease.

Area of Science:

  • Vascular Medicine
  • Diagnostic Imaging
  • Cardiovascular Surgery

Background:

  • Peripheral arterial occlusive disease (PAOD) affects numerous patients, often presenting with multiple atherosclerosis risk factors.
  • Common risk factors include smoking, diabetes mellitus, arterial hypertension, hyperlipidemia, and obesity, with distinct prevalence in men and women.
  • Simultaneous atherosclerotic changes in carotid and lower extremity arteries are frequent, necessitating comprehensive diagnostic approaches.

Purpose of the Study:

  • To evaluate the diagnostic performance of duplex sonography compared to angiography in patients with PAOD.
  • To investigate the prevalence and characteristics of atherosclerosis in patients with clinical signs of PAOD.
  • To assess the correlation between risk factors, intima-media thickness (IMT), ankle-brachial index (ABI), and atherosclerotic severity.

Main Methods:

  • Color duplex sonography and angiography were used to assess 77 patients with clinical signs of PAOD.
  • Risk factors for atherosclerosis were recorded, and intima-media thickness (IMT) of carotid arteries and ankle-brachial index (ABI) were measured.
  • Diagnostic accuracy of duplex sonography was compared to angiography, particularly in femoro-popliteal and infra-popliteal regions.

Main Results:

  • Duplex sonography demonstrated high sensitivity (98%) and specificity (100%) in the femoro-popliteal area but lower accuracy in the infra-popliteal region.
  • Pathologic IMT was found in 82% of patients, indicating widespread atherosclerotic changes.
  • Diabetic patients showed a higher prevalence of hemodynamically significant atherosclerotic changes in the infrapopliteal arteries.

Conclusions:

  • Duplex sonography is a reliable tool for diagnosing femoro-popliteal arterial disease in PAOD patients.
  • Widespread atherosclerosis is common in PAOD, affecting both carotid and lower extremity arteries.
  • Further investigation is needed to improve diagnostic accuracy of duplex sonography in the infra-popliteal vasculature.

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