Preoperative visualization of peripheral arteries with duplex ultrasonography in patients with diabetes mellitus and critical limb ischemia

Abstract

AIM: To determine whether duplex ultrasonography (DU) without verification with diagnostic angiography (DA) is a sufficient visual- ization technique for pre-operative examination of patients with CLI (critical limb ischemia) indication for percutaneous transluminal balloon angioplasty (PTBA). MATERIALS AND METHODS: We examined 254 patients (290 limbs in total) with diabetes mellitus (DM) and CLI. All participants were subdivided into two groups: ?A? (PTBA with pre-operative DU+DA) and ?B? (PTBA with pre-operative DU). We evaluated data coherence between DU and DA (pre- or intraoperative) methods, as well as DU diagnostic specificity and sensitivity in determining degree and localization of vascular lesions. We also investigated specific clinical factors compromising DU diagnostic capabilities in patients with DM. RESULTS: Our data suggests adequate coherence between DU and DA for pre-operative visualization. Group ?B? showed significantly higher diagnostic sensitivity and specificity for visualization of the lower third of superficial femoral artery and tibial arteries despite abdominal obesity, grossly evident calcification and peripheral edema. CONCLUSION: Duplex ultrasound is efficient and precise enough to determine optimal management tactics in most patients with DMand CLI without resort to invasive methods.

Keywords

• duplex ultrasonography
• critical limb ischemia
• percutaneous transluminal angioplasty
• diabetes mellitus