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Publication Date

8-14-2015

Keywords

vascular imaging, intervention, duplex ultrasound, angiography, magnetic resonance, computed tomography

Abstract

Imaging strategies for preinterventional planning in symptomatic peripheral artery disease have employed various modalities ranging from duplex ultrasound to noninvasive angiography with computed tomography (CT) or magnetic resonance (MRA). These methods have classically been compared to the gold standard of digital subtraction angiography and are reviewed here in detail through the work of relevant published studies and meta-analyses between 1996 and 2014. In particular, we focus on the diagnostic performance, reproducibility and cost-effectiveness of these aforementioned modalities with respect to mapping the lower extremity arterial tree for planning vascular intervention and surveillance. The data presented suggests comparable sensitivity and specificity of duplex ultrasound compared to contrast-enhanced MRA and CT angiography, with the potential for adequate reproducibility given the presence of an accredited vascular lab with highly trained technicians. Cost-effectiveness was shown to be favorable for duplex ultrasound as long as there is diagnostic confidence in the results, which is vital to its success as a viable imaging modality for peripheral artery disease.