Clinical Implications of the Vascular Laboratory in the Diagnosis of Peripheral Arterial Disease

2012 ◽  
pp. 425-448
Author(s):  
Ali F. AbuRahma
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Clinical Implications ◽  
Vascular Laboratory ◽  
Peripheral Arterial

The Use of Segmental Femoropopliteal Duplex Scanning for Initial Vascular Laboratory Testing of Patients with Peripheral Arterial Disease

2003 ◽  
Vol 27 (3) ◽  
pp. 157-160 ◽  
Author(s):  
Annmarie Dunican ◽  
Robert Patterson ◽  
Robert Scissons ◽  
Joseph Gillis ◽  
Albert Weyman ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Lower Extremity ◽  
Arterial Disease ◽  
Duplex Scanning ◽  
Waveform Analysis ◽  
Laboratory Evaluation ◽  
Mcnemar Test ◽  
Hands On ◽  
Vascular Laboratory ◽  
Peripheral Arterial

Introduction —Segmental femoropopliteal duplex scanning in conjunction with ankle plethysmographic waveforms and ankle/brachial indices (ABI) was evaluated as an alternative to traditional physiologic testing for the initial vascular laboratory evaluation of patients with lower extremity peripheral arterial disease (PAD). To assess the potential of this evaluation, patients with PAD were evaluated in the vascular laboratory with (1) pulse volume recording and segmental pressures (SPVR) and (2) femoropopliteal duplex imaging with pulsed Doppler waveform analysis and bilateral ankle plethysmographic waveforms and ABI (SDuplex). Methods. —SPVR and SDuplex data were prospectively obtained from 39 patients and 72 limbs. Separate technologists performed the physiologic and duplex examinations independently. Angiograms performed within 90 days were used as the gold standard for evaluating results from both procedures. Results from both examinations were interpreted for severe (>50% diameter reduction) inflow and superior femoral artery (SFA) disease. A McNemar test was performed on the SPVR and SDuplex paired data, and direct (hands-on) examination time was calculated for both procedures. Results. —Angiograms were available for 20 of 72 (28%) of the limbs evaluated and demonstrated no significant differences between both methods for evaluating inflow (femoral or above) disease, yet SDuplex was superior to SPVR for evaluating SFA disease. McNemar test data also suggested that SDuplex was superior to SPVR in diagnosing severe disease at the SFA level. The average time for SPVR examination performance was 28 minutes and 31 minutes for SDuplex with ABI and ankle waveforms. Conclusions. —SDuplex was superior to SPVR for evaluating SFA disease. No noteworthy differences in direct (hands-on) examination times for both procedures suggest the additional benefit of enhanced reimbursement. With superior SFA accuracy, more site-specific information, and greater reimbursement potential, SDuplex should be considered an alternative to the traditional physiologic examination for evaluating patients with lower extremity PAD.

scholarly journals Interarm Difference in Blood Pressure: Reproducibility and Association with Peripheral Vascular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Jesper Mehlsen ◽  
Niels Wiinberg
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Arterial Disease ◽  
Peripheral Vascular ◽  
Vascular Laboratory ◽  
Insignificant Difference ◽  
Peripheral Arterial ◽  
The Right ◽  
Diagnosis Of Hypertension

The present study aimed at examining the interarm difference in blood pressure and its use as an indicator of peripheral arterial disease (PAD). Data were included from consecutive patients referred from their general practitioner to our vascular laboratory for possible PAD aged 50 years or older without known cardiac disease, renal disease, or diabetes mellitus. 824 patients (453 women) with mean age of 72 years (range: 50–101) were included. 491 patients had a diagnosis of hypertension and peripheral arterial disease (PAD) was present in 386 patients. Systolic blood pressure was 143 ± 24 mmHg and 142 ± 24 mmHg on the right and left arm, respectively (P=0.015). The interarm difference was greater in patients with hypertension (P=0.002) and PAD (P<0.0005). 443 patients were measured on two separate occasions and the interarm difference for systolic blood pressure was reproducible for differences >20 mmHg. This study confirmed the presence of a systematic but clinically insignificant difference in systolic blood pressure between arms. The interarm difference was larger in hypertension and PAD. Consistent lateralisation is present for differences ≥20 mmHg and an interarm difference >25 mmHg is a reliable indicator of PAD in the legs.

Spectrum effect and spectrum bias in the oscillometric ankle brachial index to diagnose peripheral arterial disease: Clinical implications

2018 ◽  
Vol 272 ◽  
pp. 8-13
Author(s):  
Ángel Herráiz-Adillo ◽  
Iván Cavero-Redondo ◽  
Celia Álvarez-Bueno ◽  
Johana Bidner ◽  
Vicente Martínez-Vizcaíno ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Clinical Implications ◽  
Peripheral Arterial ◽  
Spectrum Effect

Management of Peripheral Arterial Disease

2006 ◽  
Vol 39 (3) ◽  
pp. 44
Author(s):  
WILLIAM E. GOLDEN ◽  
ROBERT H. HOPKINS
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Peripheral Arterial
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