Concordance between preoperative ultrasound arterial mapping in the femoropopliteal and distal sector and intraoperative angiography.

Aims: The present study analyzes the concordance between arterial mapping of this sector using duplex ultrasound and intraoperative angiography.

Methods: A retrospective, single-center observational study was carried out. The study sample consisted of patients subjected to open or endovascular surgery of the femoropopliteal and distal sector with prior ultrasound arterial mapping from January 2017 to December 2022. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of arterial mapping with duplex ultrasound versus intraoperative angiography were evaluated, the degree of concordance between the two techniques and the correlation between surgical planning and the surgery finally performed.

Results: 167 patients were analyzed. A total of 1837 segments were explored, of which 149 (8.1%) were not able to be evaluated. Regarding the global precision of ultrasound in predicting significant arterial lesions (stenosis > 50% or occlusion), sensitivity was 85.26% (95% confidence interval [95%CI]: 82.33-88.19%), specificity 88.57% (95%CI: 86.63-90.51%), PPV 80.41% (95%CI: 77.24-83.58%), and NPV 91.61% (95%CI: 89.89-93.34%). Global concordance assessed by the kappa index was 0.725 (95%CI: 0.691-759). The surgical indications based on arterial mapping coincided with the final surgery performed in 97.6% of the cases.

Conclusions: Arterial mapping of the femoropopliteal and distal sector with duplex ultrasound could be considered as the sole preoperative imaging technique for surgical planning.