Abstract
After a thorough evaluation is performed of the wound, it is important to further evaluate it with non-invasive imaging such as ankle-brachial indexes, pulse volume recordings, or segmental pressures. Further evaluation with Toe Pressures, TpCO2, duplex ultrasound, and/or cross-sectional imaging may be obtained in specific situations. Non-invasive imaging is essential to diagnose peripheral vascular disease treatment planning, and vascular status monitoring. It is crucial to understand the indications, interpretation, and pitfalls of each test in order to know what situations they are best utilized.
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References
Management of venous leg ulcers: Clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum O’Donnell, Thomas F. et al. J Vasc Surg. 60(2):3S–59S.
Xu D, Li J, Zou L, Xu Y, Hu D, Pagoto SL, Ma Y. Sensitivity and specificity of the ankle-brachial index to diagnose peripheral artery disease: a structured review. Vasc Med. 2010;15(5):361–9. https://doi.org/10.1177/1358863X10378376.
Strandness DE Jr, Schultz RD, Sumner DS, Rushmer RF. Ultrasonic flow detection. A useful technic in the evaluation of peripheral vascular disease. Am J Surg. 1967;113:311–20.
Wütschert R, Bounameaux H. Predicting healing of arterial leg ulcers by means of segmental systolic pressure measurements. Vasa. 1998;27:224–8.
Hafner J, et al. Leg ulcers in peripheral arterial disease (arterial leg ulcers): impaired wound healing above the threshold of chronic critical limb ischemia. J Am Acad Dermatol. 2000;43:1001–8.
Darling RC, Raines JK, Brener BJ, Austen WG. Quantitative segmental pulse volume recorder: a clinical tool. Surgery. 1972;72:873–7.
Macdonald N. Pulse volume plethysmography. J Vasc Tech. 1994;18:241–8.
Lau JF, Weinberg MD, Olin JW. Peripheral artery disease. Part 1: clinical evaluation and noninvasive diagnosis. Nat Rev Cardiol. 2011;8(7):405–18.
Cesar C, Javier E, Anaya-Ayala H, et al. Abstract 273: Measurement of transcutaneous oxygen pressure in patients with post-thrombotic syndrome and possible clinical applications. Arterioscler Thromb Vasc Biol. 2019;39:A273.
Yang C, Weng H, Chen L, Yang H, Luo G, Mai L, Jin G, Yan L. Transcutaneous oxygen pressure measurement in diabetic foot ulcers: mean values and cut-point for wound healing. J Wound Ostomy Continence Nurs. 2013;40(6):585–9. https://doi.org/10.1097/WON.0b013e3182a9a7bf.
Lo T, Sample R, Moore P, Gold P. Prediction of Wound Healing Outcome using skin perfusion pressure and transcutaneous oximetry: a single-center experience in 100 patients. Wounds. 2009;21(11):310–6.
Eiberg JP, Grønvall Rasmussen JB, Hansen MA, Schroeder TV. Duplex ultrasound scanning of peripheral arterial disease of the lower limb. Eur J Vasc Endovasc Surg. 2010;40(4):507–12.
Moneta GL, et al. Accuracy of lower extremity arterial duplex mapping. J Vasc Surg. 1992;15:275–83.
Ligush J Jr, Reavis SW, Preisser JS, Hansen KJ. Duplex ultrasound scanning defines operative strategies for patients with limb-threatening ischemia. J Vasc Surg. 1998;28:482–90.
Schernthaner R, et al. Multidetector CT angiography in the assessment of peripheral arterial occlusive disease: accuracy in detecting the severity, number, and length of stenoses. Eur Radiol. 2008;18:665–71.
Von Ziegler F, Costa MA. The role of CT and MRI in the assessment of peripheral vascular disease. Curr Cardiol Rep. 2007;9:412–9.
Collins R, et al. Duplex ultrasonography, magnetic resonance angiography, and computed tomography angiography for diagnosis and assessment of symptomatic, lower limb peripheral arterial disease: systematic review. BMJ. 2007;334:1257.
Weinreb J, Rodby R, Yee J, et al. Use of Intravenous gadolinium-based contrast media in patients with kidney disease: consensus statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2021;298(1):28–35.
Silickas J, et al. Use of computed tomography and magnetic resonance imaging in central venous disease. Methodist DeBakey Cardiovasc J. 2018;14(3):188–95. https://doi.org/10.14797/mdcj-14-3-188.
Sibley RC. et al. Noninvasive physiologic vascular studies: a guide to diagnosing peripheral arterial disease. RadioGraphics. 2017;37(1):346–57. https://doi.org/10.1148/rg.2017160044.
Sonter J, Ho A, Chuter VH. The predictive capacity of toe blood pressure and the toe-brachial index for foot wound healing and amputation: a systematic review and meta-analysis. Wound Pract Res. 2014;22(4):208–17.
Ato D. Pitfalls in the ankle-brachial index and brachial-ankle pulse wave velocity. Vasc Health Risk Manag. 2018;14:41–62. https://doi.org/10.2147/VHRM.S159437. Published 2018 Apr 3
Murphy DJ, Aghayev A, Steigner ML. Vascular CT and MRI: a practical guide to imaging protocols. Insights Imaging [Internet]. 2018;9(2):215–36. Available from: https://insightsimaging.springeropen.com/articles/10.1007/s13244-018-0597-2
Cavallo AU, Koktzoglou I, Edelman RR, Gilkeson R, Mihai G, Shin T, et al. Noncontrast magnetic resonance angiography for the diagnosis of peripheral vascular disease. Circ Cardiovasc Imaging. 2019;12(5):1–15.
Ghaye B, Szapiro D, Willems V, Dondelinger RF. Pitfalls in CT venography of lower limbs and abdominal veins. Am J Roentgenol. 2002;178(6):1465–71.
Tehan PE, Barwick AL, Sebastian M, Chuter VH. Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study. J Foot Ankle Res. 2017;10:58.
Sommerset, et al. An innovative arterial duplex examination: a guide to evaluate flow in the foot using pedal acceleration time. JVU. 2019;169;11–17.
Sommerset, et al. Plantar acceleration time: a novel technique to evaluate Flow to the foot. AVS; 2019.
Sommerset, et al. Pedal flow hemodynamics in patients with CLTI. JVU; 2019.
Teso, et al. Pedal acceleration time: a novel predictor of limb salvage. AVS; 2021.
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Costantino, M. et al. (2023). Determining the Appropriate Workup. In: Madassery, S., Patel, A. (eds) Limb Preservation for the Vascular Specialist. Springer, Cham. https://doi.org/10.1007/978-3-031-36480-8_3
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