[Ultrasound investigation of vessels supplying the extremities]

Ultrasound investigation of the vascular supply to legs and arms has become a standard procedure and is performed in all kinds of both arterial occlusive disease and venous disease. On the arterial side the most common disease is atherosclerosis in which stenoses and occlusions can be identified and characterized with respect to the functional significance. Sensitivity und specificity for the detection of symptomatic occlusions and stenoses are approximately 90% and 99%, respectively. This is the basis for planning invasive procedures, catheter interventions as well as operations. The short term success can be assessed and long term follow-up can be performed by ultrasound. In addition all other kinds of arterial disease (embolisms, aneurysms, inflammation and mechanical alterations) can be examined. On the venous side, the most common indication for ultrasound is the suspicion of deep vein thrombosis. Compression ultrasound of the leg veins allows a reliable diagnosis in almost all cases. The diagnostic failure rate in a 3-month follow up is around 0.5%. The present review summarizes the indications and examination details for leg arteries, arm arteries, leg veins and arm veins. A separate paragraph deals with dialysis shunts, a growing field in vascular medicine.