The role of duplex scanning in the diagnosis of lower limb arterial disease

Color flow duplex imaging of the iliac and femoropopliteal arteries was per formed in patients undergoing angiography. The aim of the study was to dete rmine: (1) in what percentage of patients could the iliac arteries be adequ ately visualized to enable a diagnosis, (2) the overall accuracy of duplex scanning in the diagnosis of arterial disease, and (3) whether there is a u seful duplex criterion for the selection of patients for angioplasty. One h undred and twenty patients (79 males, 41 females; mean age 64.4 years) had duplex scans prior to angiography (2-7 days) and the results were compared. The duplex criteria of an increase in the peak systolic velocity ratio (PS VR) >2 and lesions <5 cm were used to signify hemodynamically significant s tenosis (>50% narrowing), the presence of plaque and calcification in the a rterial wall with alteration of PSVR and lesions >5 cm, diffuse disease, an d the absence of flow on color/Doppler interrogation, occlusion. The result s show that duplex scanning is a useful screening tool and may be effective ly used to diagnose iliac and femoropopliteal disease in nearly 80% of pati ents. Angiography will be needed in those in whom duplex scanning is inconc lusive, or, prior to intervention in those with disease suitable for surgic al reconstruction or angioplasty, diagnosed on the basis of duplex scans.