Peripheral arterial disease screening and diagnostic practice: A scoping review

Area of Science:

• Vascular Medicine
• Diagnostic Tools
• Medical Screening

Background:

• Peripheral arterial disease (PAD) screening and diagnosis lack standardized practices.
• Variability exists in timing, frequency, setting, and clinician involvement in PAD diagnostics.
• Reliability and validity of PAD screening tools are crucial for improving patient outcomes.

Purpose of the Study:

• To review the reliability and validity of diagnostic and screening tools for peripheral lower leg ischaemia.
• To summarize the performance of various tools for non-neuropathic lower leg ischaemia.
• To inform clinical and referral decisions by assessing diagnostic tool efficacy.

Main Methods:

• A scoping literature review of clinical studies from the PubMed database (1970-2018).
• Focused on reliability and validity of peripheral ischaemia diagnostic and screening tools.
• Included studies on non-neuropathic lower leg ischaemia.

Main Results:

• Ankle-brachial systolic blood pressure index <0.9 is a reliable and valid screening test for lower leg ischaemia, prompting specialist referral.
• Toe-brachial index and claudication assessment are reliable for advanced PAD or calcified arteries.
• Invasive angiographic techniques are valid diagnostic tools but carry potential complications.

Conclusions:

• Ankle-brachial index testing is reliable and valid for routine screening of peripheral ischaemia.
• Standardized use of ankle-brachial index improves screening consistency and timely referral.
• Accurate diagnosis through specialist referral using Doppler or other methods is essential for effective treatment decisions.