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Level of Agreement Between Systematic Doppler Examination of the Lower Extremity and Diagnostic Angiography in the Setting of Peripheral Arterial Disease

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Background

The objective of this investigation was to determine the level of agreement between a systematic clinical Doppler examination of the foot and ankle and diagnostic peripheral angiography.

Methods

The described Doppler examination technique attempted to determine the patency, quality, and direction of the flow through the dorsalis pedis artery, posterior tibial artery, terminal branches of the peroneal artery, and vascular arch of the foot. These results were then compared with angiographic distal run-off images as interpreted by a blinded vascular surgeon.

Results

Levels of agreement with respect to artery patency/quality ranged from 64.0% to 84.0%. Sensitivity ranged from 53.8% to 84.2%, and specificity ranged from 64.7% to 91.7%. Agreement with respect to arterial flow direction ranged from 73.3% to 90.5%.

Conclusions

We interpret these results to indicate that this comprehensive physical examination technique of the arterial flow to the foot and ankle with a Doppler device might serve as a reasonable initial surrogate to diagnostic angiography in some patients with peripheral arterial disease.

Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA.

Department of Vascular Surgery, Temple University School of Medicine, Philadelphia, PA.

Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

Corresponding author: Andrew J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 8th at Race Street, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)