Preoperative mapping of the aortoiliac territory with duplex ultrasound in patients with peripheral arterial occlusive disease

Méndez, Miguel Muela; Barrado, Pilar Caridad Morata; Cañibano, Estrella Blanco; Fresnillo, Beatriz García; Requena, Mercedes Guerra

doi:10.1016/j.jvs.2017.11.082

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…However, it should be noted that this sensitivity could be lower for the aorto‐iliac trajectory because of obesity or over‐projection of bowel gas. A study found that 10.4% of all duplex images of the aorto‐iliac trajectory could not be evaluated because of these reasons [ 36 ]. Another study found a low inter‐observer agreement for duplex ultrasound in the case of the aorto‐iliac trajectory (kappa of 0.53) [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

To screen or not to screen? The development of a prediction model for aorto‐iliac stenosis in kidney transplant candidates

Rijkse

Babakry

et al. 2021

Transpl Int

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Screening for aorto-iliac stenosis is important in kidney transplant candidates as its presence affects pre-transplantation decisions regarding side of implantation and the need for an additional vascular procedure. Reliable imaging techniques to identify this condition require contrast fluid, which can be harmful in these patients. To guide patient selection for these imaging techniques, we aimed to develop a prediction model for the presence of aorto-iliac stenosis. Patients with contrast-enhanced imaging available in the pre-transplant screening between January 1st, 2000 and December 31st, 2018 were included. A prediction model was developed using multivariable logistic regression analysis and internally validated using bootstrap resampling. Model performance was assessed with the concordance index and calibration slope. Three hundred and seventy-three patients were included, 90 patients (24.1%) had imaging-proven aorto-iliac stenosis. Our final model included age, smoking, peripheral arterial disease, coronary artery disease, a previous transplant, intermittent claudication and the presence of a femoral artery murmur. The model yielded excellent discrimination (optimism-corrected concordance index: 0.83) and calibration (optimismcorrected calibration slope: 0.91). In conclusion, this prediction model can guide the development of standardized protocols to decide which patients should receive vascular screening to identify aorto-iliac stenosis. External validation is needed before this model can be implemented in patient care.

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Section: Discussionmentioning

confidence: 99%

To screen or not to screen? The development of a prediction model for aorto‐iliac stenosis in kidney transplant candidates

Rijkse

Babakry

et al. 2021

Transpl Int

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“…In comparison to CT, DUS had low accuracy reports, with cases ranging from 5.6 mm smaller to 11.6 mm bigger than the reported diameter on CT [23]. Moreover, DUS underestimates the degree of stenosis compared to CTA (degree of concordance has been reported in more studies [5,24] between DUS and CTA: common iliac: 0.8 (0.71-0.88), right external iliac: 0.84 (0.76-0.92), left external iliac: 0.71 (0.61-0.81)) or MRA (degree of concordance between DUS and MRA: 86%). DUS provides a moderate to strong correlation with MRI [12].…”

Section: Diagnostic Methodsmentioning

confidence: 97%

“…In native arteries, DUS had a PSV = 180 cm/s, 80% specificity, and 66% sensitivity for >50% stenosis [ 20 ]. There is a strong degree of concordance between DUS and CTA in the right femoral (0.82 [0.69-0.95]) and left femoral (0.88 [0.76-1]) arteries [ 24 ]. In the femoropopliteal segments, DUS provided 94.8% sensitivity, 80.2% specificity, 94.1% PPV, 89.0% NPV, and 90.1% accuracy [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

Peripheral Arterial Disease: A Narrative Review

Parwani¹,

Ahmed²,

Mahawar³

et al. 2023

Cureus

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Peripheral arterial disease (PAD) describes the partial or complete occlusion of blood flow in the distal arteries of the body. A decreased arterial patency may occur due to a reduction in the elasticity or diameter of the vessel. The goal of interventions is to decrease incidence and reduce complications by identifying and minimizing the primary causes. This paper discusses PAD affecting the aortoiliac, common femoral, and femoropopliteal arteries. In a significant portion of the population, PAD may lack usual symptoms such as limb pain, claudication, and diminished pulses. Imaging techniques become crucial to ensuring timely diagnosis, monitoring treatment effectiveness, and preventing recurrence. Duplex ultrasound (DUS) is a cheap and non-invasive preliminary technique to detect atherosclerotic plaques and grade arterial stenosis. Magnetic resonance angiography (MRA) provides the added advantage of minimizing artifacts. Digital subtraction angiography (DSA) remains the gold standard for grading the degree of stenosis but is only employed second-line to DUS or MRA due to the high dose of nephrotoxic contrast. Computed tomography angiography (CTA) is able to overcome the anatomical limitations of DUS and MRA and proves to be a suitable alternative to DSA in patients with renal disease. Preventative measures involve monitoring blood pressure, cholesterol levels, and tobacco usage. First-line treatment options include endovascular procedures as well as surgical interventions in cases of significant arterial involvement. Endovascular treatments involve the use of balloon angioplasty, drug-coated balloons, and drug-coated stents, to name a few, that serve as minimally invasive techniques to manage PAD. Surgical procedures, although more complex, are considered gold-standard treatment options for long and intricate lesions. Endovascular methods are generally preferred over surgical options as the complication risk is severely reduced and the rates of reintervention are comparable to surgical options.

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Concordance between preoperative ultrasound arterial mapping in the femoropopliteal and distal sector and intraoperative angiography

Barrado,

Méndez,

Palenzona

et al. 2024

J Ultrasound

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Preoperative mapping of the aortoiliac territory with duplex ultrasound in patients with peripheral arterial occlusive disease

Abstract: DUS mapping of the aortoiliac territory could be used as a single preoperative imaging test in aortoiliac occlusive disease in patients whose DUS examination is able to be evaluated.

Cited by 5 publications

References 27 publications

To screen or not to screen? The development of a prediction model for aorto‐iliac stenosis in kidney transplant candidates

To screen or not to screen? The development of a prediction model for aorto‐iliac stenosis in kidney transplant candidates

Peripheral Arterial Disease: A Narrative Review

Concordance between preoperative ultrasound arterial mapping in the femoropopliteal and distal sector and intraoperative angiography

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