Peripheral arterial disease ultrasound: Difference between revisions
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1. Duplex ultrasound of the extremities can be useful to | |- | ||
select patients as candidates for endovascular intervention. | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA Guidelines Classification Scheme#Classification of Recommendations|Class IIa]] | ||
(Level of Evidence: B) | |||
2. Duplex ultrasound can be useful to select patients as | |- | ||
candidates for surgical bypass and to select the sites of | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Duplex ultrasound of the extremities can be useful to select patients as candidates for endovascular intervention. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
surgical anastomosis. (Level of Evidence: B) | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Duplex ultrasound can be useful to select patients as candidates for surgical bypass and to select the sites of surgical anastomosis. ''([[ACC AHA Guidelines Classification Scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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==References== | ==References== | ||
Revision as of 15:11, 10 October 2012
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Peripheral arterial disease Microchapters |
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Differentiating Peripheral arterial disease from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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AHA/ACC Guidelines on Management of Lower Extremity PAD |
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Guidelines for Structured Exercise Therapy for Lower Extremity PAD |
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Guidelines for Minimizing Tissue Loss in Lower Extremity PAD |
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Guidelines for Revascularization of Claudication in Lower Extremity PAD |
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Guidelines for Management of Acute Limb Ischemial in Lower Extremity PAD |
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Guidelines for Longitudinal Follow-up for Lower Extremity PAD |
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Peripheral arterial disease ultrasound On the Web |
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American Roentgen Ray Society Images of Peripheral arterial disease ultrasound |
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Directions to Hospitals Treating Peripheral arterial disease |
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Risk calculators and risk factors for Peripheral arterial disease ultrasound |
Editors-in-Chief: C. Michael Gibson, M.D., Beth Israel Deaconess Medical Center, Boston, MA; Robert G. Schwartz, M.D. [1], Piedmont Physical Medicine and Rehabilitation, P.A.; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
Ultrasound
- Ultrasound is somewhat insensitive in making the diagnosis of PVD.
- Duplex ultrasound
- Benefits
- Can establish the lower extremity PAD diagnosis, establish localization, and define severity of local lower extremity arterial stenoses
- Can be useful to select candidates for endovascular or surgical revascularization
- Limitations
- Accuracy is diminished in proximal aortoiliac arterial segments in some individuals
- Dense arterial calcification can limit diagnostic accuracy
- Sensitivity is diminished for detection of stenoses downstream from a proximal stenosis
- Diminished predictive value in surveillance or prosthetic bypass grafts
- Benefits
ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic) (DO NOT EDIT)[1]
Recommendations for Duplex Ultrasound
| Class I |
| "1. Duplex ultrasound of the extremities is useful to diagnose anatomic location and degree of stenosis of PAD. (Level of Evidence: A)" |
| "2. Duplex ultrasound is recommended for routine surveillance after femoral-popliteal or femoral-tibialpedal bypass with a venous conduit. Minimum surveillance intervals are approximately 3, 6, and 12 months, and then yearly after graft placement. (Level of Evidence: A)" |
| Class IIa |
| "1. Duplex ultrasound of the extremities can be useful to select patients as candidates for endovascular intervention. (Level of Evidence: B)" |
| "2. Duplex ultrasound can be useful to select patients as candidates for surgical bypass and to select the sites of surgical anastomosis. (Level of Evidence: B)" |
References
- ↑ Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM, White CJ, White J, White RA, Antman EM, Smith SC, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B (2006). "ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation". Circulation. 113 (11): e463–654. doi:10.1161/CIRCULATIONAHA.106.174526. PMID 16549646. Retrieved 2012-10-09. Unknown parameter
|month=ignored (help)