Noninvasive localization of infrainguinal arterial occlusive disease in diabetics

A retrospective review of 101 diabetics without aortoiliac disease was carr ied out to analyze the ability of various noninvasive tests to predict the level of significant (>50% stenosis) infrainguinal arterial disease. Patien ts were studied with anklebrachial indices (ABI), toebrachial indices (TBI) , segmental pulse volume recordings (PVR), segmental pressures (SEGP), segm ental Doppler waveforms (DWF), and arteriography. Results were classified a s normal, disease at the femoropopliteal level, infrapopliteal level, or bo th levels (multilevel), or noninterpretable. Our findings for the entire st udy showed that, as a single test, DWF appears to have the best angiographi c correlation, although the summed diagnosis of combined DWF and PVR data i s superior in distinguishing multilevel disease from isolated tibial diseas e. SEGP are of very limited use in diabetics, even in multimodality testing , and we no longer include that test in our routine evaluation of diabetics .