Purpose: To evaluate the agreement of duplex ultrasound (DUS) versus digital subtraction angiography (DSA) for assessment of femoropopliteal arterial disease in a real-world clinical setting.
Methods: Consecutive patients with peripheral artery disease who were scheduled for a percutaneous intervention were included in this retrospective study. During an 18-month period, 491 patients (276 men; median age 73 years, interquartile range 64-81) were enrolled. A peak systolic velocity ratio (PSVR)>2.4 was the optimal cutoff for detecting a >50% stenosis by DSA. Findings of preprocedural DUS in the proximal, middle, and distal ipsilateral superficial femoral artery and in the popliteal segment were analyzed for agreement with preprocedural femoropopliteal DSA using kappa statistics. Only the target limb in each patient was analyzed, for a total of 1964 vascular segments.
Results: Agreement for the degree of stenosis in 10% increments was only moderate (weighted kappa 0.67, 95% CI 0.65 to 0.69). Using the PSVR>2.4 cutoff, agreement between DUS and DSA for a >50% stenosis was good (kappa 0.79, 95% CI 0.77 to 0.81). Sensitivity, specificity, positive predictive value, and negative predictive value for correctly detecting a >50% stenosis by DUS were 0.81 (0.78 to 0.84), 0.93 (0.91 to 0.94), 0.84 (0.81 to 0.87), and 0.91 (0.87 to 0.95), respectively. Comparable findings were observed within different patient subgroups.
Conclusion: Agreement between DUS and DSA in the femoropopliteal segment is only moderate with respect to the absolute degree of stenosis. However, detection of a >50% stenosis can be done with acceptable precision in routine clinical practice using PSVR>2.4 as a threshold.
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http://dx.doi.org/10.1177/152660280701400404 | DOI Listing |
Kardiol Pol
January 2025
Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland.
Background: Preliminary research indicates that higher iron levels are associated with worse outcomes in patients with coronary artery disease.
Aims: The study aimed to investigate the relationship between iron levels and the type and composition of coronary plaques.
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Int J Stroke
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background: Covert brain infarction (CBI) is common and poses a potential and non-negligible burden of disease worldwide. The prevalence and risk factors for CBI have been reported inconsistently in previous studies.
Aims: This study aims to ascertain the prevalence and risk factors of CBI and its imaging phenotypes in community-dwelling adults.
The broad spectrum of clinical manifestations caused by peripheral arterial disease [PAD] and the morphologic heterogeneity of associated atherosclerotic lesions present a considerable management challenge. Endovascular interventions are recognized an effective treatment for PAD. Within this revascularization strategy the role of atherectomy debulking modalities continue to evolve.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Health and Care Professions, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.;
Background: Coronary artery disease (CAD), primarily caused by atherosclerosis, is a leading cause of death, presenting as angina or myocardial infarction. Advances in cardiac imaging, angiography, and procedures like percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery have improved early detection and management of this condition. This report presents the case of a man who experienced worsening exertional chest pain and discomfort while at rest.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Vascular Surgery, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria.
Introduction And Importance: Leriche syndrome (LS), or aortoiliac occlusive disease, is a rare form of peripheral arterial disease leading to claudication, impotence, and diminished femoral pulses due to atheromatous obstruction of the infrarenal aorta and common iliac arteries. Early identification is crucial as untreated LS can result in severe complications. Treatment primarily involves surgical interventions, with endovascular options considered as alternatives.
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