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Year : 2005  |  Volume : 15  |  Issue : 4  |  Page : 587-588
Color duplex evaluation of peripheral arterial occlusive disease of lower extremities and to determine relationship between severity and number of collaterals associated


Department of radiology, RNT Medical College, India

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   Abstract 

Materials and methods : 80 Limbs were studied with perepheral arterial occlusive disease (PAOD)BY COLOR DUPLEX SONOGRAPHY(CDS) ;and were evaluated for the presence of collaterals. Results : By CDS evaluation for collaterals;it was found that number of collaterals increased with the severity of areterial stenosis Conclusion : Number and freqency of collaterals seen in patients with PAOD depends upon severity of PAOD.

Keywords: Peripheral arterial occlusive disease (PAOD); color duplex sonography(CDS)

How to cite this article:
Sharma N C, Meena M L. Color duplex evaluation of peripheral arterial occlusive disease of lower extremities and to determine relationship between severity and number of collaterals associated. Indian J Radiol Imaging 2005;15:587-8

How to cite this URL:
Sharma N C, Meena M L. Color duplex evaluation of peripheral arterial occlusive disease of lower extremities and to determine relationship between severity and number of collaterals associated. Indian J Radiol Imaging [serial online] 2005 [cited 2020 Oct 30];15:587-8. Available from: https://www.ijri.org/text.asp?2005/15/4/587/29180

   Introduction Top


Peripheral arterial occlusive disease is the most common disease of extremity arteries And is characterised by narrowing of the extremity arteries causing a reduction in blood flow and ischemic changes in the limbs affected. Approximately 90% of patients show involvement of lower extremity arteries. Signs and symptoms of PAOD depends on presence or absence of collaterals.

Hemodynamic circuit consist of diseased major artery, a parallel system of collaterals and the peripheral run off bed. Collaterals vessels are much smaller more circuitous and more numerous then the major arteries. They replace and always have a higher resistance then the original unobstructed artery. Stimuli for development of collaterals are the presence of abnormal pressure gradient across the collaterals system and increased velocity of flow through intramuscular channels.


   Materials and methods Top


over a period of one year extending from march 2003 to march 2004 80 limbs were studied with TOSHIBA NEMIO-30 color duplex machine of which 24 limbs[30% of total] showed the presence of collaterals.

Presence and grading of PAOD by doppler criteria.

Presence of collaterals identified by CDS proximal to the stenotic lesion[a major muscular branch]

Origin and re-entry of collaterals identified where ever possible

Decreased resistance to blood flow in collaterals compared to the diseased major artery.


   Results Top


CDS showed the presence of peripheral arterial occlusive disease displaying increased velocity of blood flow within stenosed arterial segment and turbulance with increased velocity of blood flow in post stenotic segment, a parallel system of collaterals with high resistance blood flow and peripheral run off. It was found that the number of collaterals increased with increased severity of arterial stenosis.

Grades of arterial stenosisTotal number of limbs Percentage of total[%]




   Discussion Top


PAOD is the most common disease of the lower extremity. Clinical presentation and treatment are significantly modified by presence and efficiency of collaterals .

Collaterals. are more frequently found in chronic and high grades of stenosis by CDS. Following CDS evaluation for collaterals it was found that out of 80 limbs showing the presence of PAOD 24 limbs showed that presence of collaterals and the frequency of collaterals increased in arterial occlusion (90.90%); followed by severe arterial stenosis(62.50%)[8]

 
   References Top

1.Jager KA, Phillips DJ, Martin RL, et al. Noninvasive mapping of lower limb arterial lesions. Ultrasound Med Biol 1985; 11 : 515-521.  Back to cited text no. 1  [PUBMED]  
2.Kenneth J.W. Taylor; Arterial vascular ultrasonography. The Radiologic Clinics of North America. Sep. 1992, 30:5.  Back to cited text no. 2    
3.Whelan JF, Barry MH, Moir JD, Color flow Dropper ultrasonography : Comparison with peripheral arteriography for investigation of peripheral vascular disease. JCVJ Clin. Ultrasound 1992, 20 : 369-74.  Back to cited text no. 3    
4.Feigelson HS, Lirqui MH, Fronek A, Langer D and Molgaard CA : Screening for peripheral arterial disease : the sensitivity, specificity and predictive value of non-invasive tests in a defined population - Am. J. Epidemion 140: 526-34, 1994.  Back to cited text no. 4    
5.Color coded duplex sonography of arteries of the lower extremities - Possibilities for diagnosis and therpy follow up - Vasa Suppl. 1991; 32: 113-21 - Neurburg Heuslev D. Karasch J.  Back to cited text no. 5    
6.Kohler T.R., G. Andros, J.M. Porter, A Clowes, J. Goldstone, K. Johanson E. Raker, D.R.Nanee : Can duplex scanning replace arteriography for lower extremity arterial disease? Ann. Vasc. Surg. 4 (1990): 280-287.  Back to cited text no. 6    
7.Allard L, Cloutier G, Durand LG, et al: Limitations of ultrasonic duplex scanning for diagnosing of lower limb arterial stenosis in the presence of adjacent segment disease. J. Vasc. Surg. 19: 650-657, 1994.  Back to cited text no. 7    
8.Zwiebel, W.J.: introduction to vascular USG Orlanda (1986)  Back to cited text no. 8    

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Correspondence Address:
N C Sharma
Department of radiology, RNT Medical College
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.29180

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