Do Doppler waveforms at the common femoral artery accurately predict iliac stenosis?

O’Neill, Stephen; George, Roy; Wallace, W. Dean; Blair, Paul; McKinley, A.

doi:10.1007/s11845-010-0538-7

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…The marginal PPV (65.22%) does not allow the use of an AHDU as a conclusive diagnostic test or facilitate mapping of arterial segments for further investigations and possible arterial interventions (angioplasty or bypass). 12,13 The limitations of our study include a medium-sized sample and relatively small number of subjects assessed for interrater reliability. However, the high positive LR shows that results are consistent and reproducible.…”

Section: Discussionmentioning

confidence: 94%

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Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

et al. 2015

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

et al. 2015

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“…Normal patients have an arterial signal that is triphasic but this signal becomes progressively biphasic and then monophasic when the vessel is calcified, because of loss of recoil in the arterial wall. In a retrospective study of MRAverified iliac artery stenosis, abnormal Doppler waveforms (monophasic/biphasic) were found in 86% of patients, with a sensitivity of 86%, but specificity was only 57% (65). Other authors use only monophasic signals as their definition of abnormal to increase specificity (26).…”

Section: Synopsismentioning

confidence: 99%

Management of peripheral vascular disease compromising renal allograft placement and function: review of the literature with an illustrative case

Gill

Shapiro

Kayler

2010

Clinical Transplantation

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As the average age of a renal transplant candidate increases, the challenge of managing recipient vascular disease affecting renal allograft function will become more common. Pre-operative screening can reveal the presence of atheromatous disease that could adversely affect allograft transplantation and function, but parameters for successful screening have not been established. Treatment options include pre-operative revascularization, concurrent therapy or delayed revascularization. Endovascular therapies have burgeoned but surgical correction is still required for some of the more complex, long-segment lesions. Potential surgical interventions range from endarterectomy to aorto-iliac bypasses. We present a case of immediate post-operative revascularization using a femoro-femoral bypass to salvage a renal allograft. The literature is reviewed to assess best practices for detecting peripheral vascular disease in renal transplant candidates and subsequent management options.

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“…When arteriography was used as a reference method, visual assessment of Doppler waveform in the common femoral arteries had high sensitivity, specificity, positive and negative predictive value for significant aorto-iliac stenoses or occlusions [9, 10]. However, in studies that used MR angiography as a reference method, the results were reported to be significantly worse [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

Echocardiographic evaluation of aorto-iliac occlusive disease

Styczyński

Szmigielski

Kaczyńska

et al. 2011

Int J Cardiovasc Imaging

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Several studies demonstrated feasibility of visual assessment of the common femoral artery Doppler waveform, in an indirect evaluation of aorto-iliac segment stenosis. Patients with cardiac diseases referred for echocardiography often have coexistent arterial pathology. Since many of them are potential candidates for endovascular procedures, we decided to study, whether echocardiography can be useful for detection of aorto-iliac occlusive disease. We evaluated 92 patients with abdominal aortic aneurysm or peripheral artery occlusive disease, referred from the vascular surgery department for cardiac evaluation before surgery. At the end of an echocardiographic examination, evaluation of flow in the distal external iliac arteries with an echocardiographic probe was performed. The Doppler waveform was classified into normal—with early diastolic flow reversal or abnormal—without early diastolic flow reversal. Echocardiographic results were compared in a blinded fashion with reports from computed tomography angiography. Overall there were 58 iliac segments with significant (≥70%) area stenosis or occlusion and 126 iliac segments without significant disease on computed tomography angiography. Abnormal Doppler waveform was found in 56 out of 58 abnormal iliac segments—sensitivity 97%, and normal waveform was found in 106 out of 126 normal iliac segments—specificity 84%. Positive predictive value of abnormal Doppler waveform for significant iliac disease was 74%, and negative predicting value was 98%. Detection of significant stenoses in aorto-iliac segments is feasible with echocardiography. Further studies are necessary to evaluate its potential utility in a population of patients with cardiac disease referred for echocardiographic study.

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Do Doppler waveforms at the common femoral artery accurately predict iliac stenosis?

Abstract: Whilst CFA waveform morphology is a useful adjunct in detection of iliac disease, normal triphasic waveforms do not exclude iliac stenosis.

Cited by 6 publications

References 10 publications

Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

Audible handheld Doppler ultrasound determines reliable and inexpensive exclusion of significant peripheral arterial disease

Management of peripheral vascular disease compromising renal allograft placement and function: review of the literature with an illustrative case

Echocardiographic evaluation of aorto-iliac occlusive disease

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