DIAGNOSIS OF ARTERIAL-DISEASE OF THE LOWER-EXTREMITIES WITH DUPLEX ULTRASONOGRAPHY

The development of duplex scanning carries the prospect of an entire n on-invasive work-up of patients with peripheral arterial occlusive dis ease, To obtain the best available estimates of its diagnostic accurac y, a metaanalysis of 71 studies evaluating duplex scanning was perform ed. Independent methodological judgement left 16 studies for data extr action, Pooled estimates (95 per cent confidence interval of sensitivi ty and specificity for detection of a stenosis greater than or equal t o 50 per cent or occlusion in the aortoiliac tract were 86 (80-91) per cent and 97 (95-99) per cent respectively. The results for the femoro popliteal tract compared well with this, with a sensitivity of 80 (74- 85) per cent and a specificity of 96 (94-98) per cent. The accuracy of detection of a stenosis greater than or equal to 50 per cent or an oc clusion in the infragenicular arteries was lower with a sensitivity an d specificity of 83 (59-96) per cent and 84 (69-93) per cent respectiv ely. Duplex scanning is an accurate tool for assessment of atheroscler otic lesions in the aortoiliac and femoropopliteal tract and can repla ce routine pre-interventional angiography in a substantial number of p atients.