VALUE OF DUPLEX SCANNING IN EVALUATION OF CRURAL AND FOOT ARTERIES INLIMBS WITH SEVERE LOWER-LIMB ISCHEMIA - A PROSPECTIVE COMPARISON WITHANGIOGRAPHY

Objectives: To compare Duplex scanning with angiography for evaluation of crural and pedal arteries in limbs with lower limb ischaemia. Desi gn: The findings obtained during Duplex scanning and angiography were prospectively compared in a blinded manner: Setting: Departments of Su rgery, Diagnostic Radiology and Clinical Physiology, University Hospit al. Materials: Duplex scanning and selective angiography of femoropopl iteal, crural and foot arteries were performed in 40 limbs (38 patient s, 480 segments) with intermittent claudication (n = 6), rest pain (n = 13) and ulcer/gangrene (n = 19). Each arterial segment were graded i nto four categories: normal, less than or equal to 50% diameter reduct ion, >50% diameter reduction and occlusion. Pedal arteries were evalua ted as patency or occlusion of dorsal pedal artery and plantar arch. C hief outcome measures: Accuracy (AC), sensitivity (SE), specificity (S P), positive predictive (PPV), negative predictive (NPV) and kappa val ues. Main results: The Duplex scanning of the tibioperoneal trunk, cru ral and pedal arteries had an accuracy of 80% (kappa = 0.6). The SE, S P, PPV and NPV values were 83%, 77%, 79% and 81%, respectively. The SP was relatively low for the peroneal artery (58%) compared to the othe rs. Conclusions: The results demonstrate the feasibility and reliabili ty of Duplex scanning in detecting crural and pedal artery lesions in lower limbs with severe ischaemia.