scholarly journals Comparison of Color Doppler and computed tomography angiography (CTA) in arterial disease in patients with lower limb ischemia.

2021 ◽  
Vol 28 (10) ◽  
pp. 1381-1391
Author(s):  
Muhammad Zakir ◽  
Anjum Tazeen ◽  
Faisal Nadeem Khan ◽  
Mehreen Fatima ◽  
Javed Tauqir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
Color Doppler ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Cross Sectional ◽  
Lower Limb Ischemia ◽  
Peripheral Arterial

Objective: To compare the diagnostic accuracy of color Doppler ultrasound with computed tomography angiography in patients with lower limb ischemia and to assess the severity of stenosis. Study Design: Cross Sectional Analytical study. Setting: Shalamar Hospital, Lahore. Period: May 2020 to October 2020. Material & Methods: Data were collected according to the Age, Height, Weight, BMI, Duration of diabetes, Total Cholesterol, LDL, HDL, Triglyceride, Gender, Socioeconomic status, Diabetes, Hypertension, Stenosis, Collateral, calcification. Sample size of46 patients were included in this research comprising 32 males (69.6%) and 14 females (30.4%).Data entry and analysis will be done by using SPSS version-23. Results: Total numbers of 46 patients were included in this research comprising 32 males (69.6%) and 14 females (30.4%). According to the result analysis 34 patients had shown peripheral arterial disease at color Doppler and 12 patients had not shown peripheral arterial disease at color doppler. 38 patients had shown peripheral arterial disease at CTA and 8 patients had not shown peripheral arterial disease at CTA. Conclusion: This study concludes that computed tomography angiography for detection of peripheral arterial disease as the gold standard, MDCT angiography shows higher sensitivity (82.6%) than color-coded Doppler ultrasonography (73.9%) in the assessment of peripheral arterial disease.

scholarly journals Genetics of Vascular Inflammation in Lower Limb Ischemia: The TNF-α Hypothesis in Peripheral Arterial Disease

2021 ◽  
Author(s):  
Diego Caicedo ◽  
Clara V. Álvarez ◽  
Sihara Pérez ◽  
Jesús Devesa
Keyword(s):  
Peripheral Arterial Disease ◽  
Mrna Expression ◽  
Lower Limb ◽  
Vascular Inflammation ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Lower Limb Ischemia ◽  
Hs Crp ◽  
Peripheral Arterial

Background: Vascular inflammation plays a crucial role in peripheral arterial disease (PAD), although the role of the mediators involved has not yet been properly defined. The aim of this work is to investigate gene expression and plasma biomarkers in chronic limb-threating ischemia (CLTI). Methods: Using patients from the GHAS trial, both blood and ischemic muscle samples were obtained to analyze plasma markers and mRNA expression, respectively. Statistical analy-sis was performed by using univariate (Spearman, t-Student, X2) and multivariate (multiple lo-gistic regression) tests. Results: 35 patients were available at baseline (29 for mRNA expression). Baseline characteristics (mean): Age:71.4±12.4 (79.4% male); TNF-α:10.7±4.9; hs-CRP:1.6±2.2; Neutrophil-to-lymphocyte ratio (NLR):3.5±2.8. Plasma TNF-α was found elevated (≥8.1) in 68.6% of patients, while high hs-CRP (≥0.5) in 60.5%. Diabetic patients with high level of inflammation showed significantly higher levels of NOX4 expression at baseline (p=0.0346). Plasma TNF-α had a negative correlation with eNOS expression (-0.5, p=0.015) and hs-CRP with VEGF-A (-0.63, p=0.005). The expression of NOX4 was parallel to that of plasma TNF-α (0.305, p=0.037), especial-ly in DM. Cumulative mortality at 12-month was related to NLR ≥3 (p=0.019) and TNF-α ≥8.1 (p=0.048). The best cut-off point for NLR to predict mortality was 3.4. Conclusions: NOX4 and TNF-α are crucial for the development and complications of lower limb ischemia, especially in DM. hs-CRP could have a negative influence on angiogenesis too. NLR and TNF-α represent suita-ble markers of mortality in CLTI. These results are novel because they connect muscle gene expres-sion and plasma information in patients with advanced PAD, deepening the search of new and ac-curate targets for this condition.

scholarly journals Bridging Therapy Using B-SES for Peripheral Arterial Disease Patients with Severe Lower Limb Ischemia

2018 ◽  
Vol 33 (3) ◽  
pp. 545-548
Author(s):  
Kaori OCHIAI ◽  
Yuuma TAMURA ◽  
Kyousuke EHARA ◽  
Riha SHIMIZU ◽  
Yasushi MATUSHITA ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Bridging Therapy ◽  
Lower Limb Ischemia ◽  
Peripheral Arterial

The Role of Doppler Ultrasound, CT Angiography, and Conventional Angiography in Detection of Peripheral Arterial Disease

2021 ◽  
pp. 154431672110303
Author(s):  
Sayan Sarkar ◽  
Shyam Mohan ◽  
Shakthi Parvathy
Keyword(s):  
Computed Tomography ◽  
Peripheral Arterial Disease ◽  
Ct Angiography ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Color Doppler ◽  
Statistical Significance ◽  
Arterial Disease ◽  
P Value ◽  
Peripheral Arterial

The purpose of this study is to analyze how accurate duplex ultrasonography using color Doppler and computed tomography (CT) angiography are in detection of peripheral arterial disease (PAD) in comparison with the Gold Standard of digital subtraction angiography (DSA). This is a single-center prospective, analytical study done on patients with symptoms of PAD referred to the Department of Radiodiagnosis of Medical Trust Hospital (n = 53). All patients were imaged with color Doppler, CT angiography, and DSA. The peak systolic velocity (PSV) ratio was calculated by Doppler ultrasound, and the percentage stenosis for the same vascular segments was calculated using CT angiography and DSA. To test the statistical significance between the results, chi-square test was used. A P value <.05 indicates statistical significance. The PSV ratio for each grade—normal (<1.5), mild (1.5-2.8), moderate (2.9-4.9), and severe (≥5)—and the percentage of stenosis for each grade observed on CT angiography—normal (<20% stenosis), mild (20%-49% stenosis), moderate (50%-74% stenosis), severe (75%-99% stenosis), and total occlusion (100% stenosis)—were found to be highly sensitive and specific with good positive predictive value, negative predictive value, and accuracy level when compared with DSA with narrow confidence intervals for each range. The P value was <.001 for both color Doppler and CT angiography. Computed tomography angiography can be an effective tool as an alternative to DSA for gradation of stenosis if the artifacts resulting from vascular calcification can be avoided. Duplex ultrasonography can be utilized for gradation of stenosis by using the value of PSV ratio and spectral pattern together. However, it can only act as an adjunct to CT angiography because it is incapable of imaging the full length of the arterial segments in 1 frame.

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