Doppler ultrasound offers accurate, accessible alternative for diagnosing peripheral artery disease
Experts believe Doppler ultrasound may represent a noninvasive way to diagnose peripheral artery disease (PAD) much earlier than current methods.
PAD reduces bloodflow to the lower extremities, progressing in severity over time. It can cause pain, ulcers, slow healing and can lead to amputation if its diagnosis is delayed, which is often the case.
The toe brachial index (TBI)—a blood pressure measurement taken from the toe—is typically used to diagnose PAD below the ankle, but its accuracy varies, especially for patients with diabetes. As such, there is an unmet need to find a method that can help providers more reliably identify patients with deteriorating circulation before it progresses in severity.
The ankle-brachial pressure index (ABPI) is known to be a reliable marker for diagnosing PAD at the ankle and above. It can be measured via ankle Doppler acceleration index (AccI) using Doppler ultrasound, and experts hypothesize this method can be extended to the foot for TBI estimation.
“This method does not require compression, and it performs better than standard ABPI in diagnosing PAD, independent of diabetes mellitus. Further work showed that post-procedural eABPI predicts one-year outcome after lower-limb angioplasty in patients with chronic limb-threatening ischemia,” lead author Christian Heiss, professor of cardiovascular medicine at the University of Surrey in England, and colleagues explained. “We hypothesized that the method could be extended below the ankle, to estimate TBI reliably from metatarsal artery wave form characteristics.”
To test their theory, researchers recently assessed the use of Doppler on 155 limbs of patients who were undergoing treatment for PAD. The exams were compared to standard TBI assessments the patients had already completed to determine accuracy.
The team found the Doppler exams to be both quicker and more accurate compared to the standard of care. What’s more, Doppler assessments were more reproducible, providing consistency across multiple users and equipment. The method also was reliable in determining treatment effectiveness.
“This research could lead to earlier diagnosis and more effective management of PAD, especially for people with diabetes and those at higher risk of heart diseases, which could result in preventing serious complications like foot ulcers and amputations,” the authors concluded.
The group believes the method could be easily integrated into clinical settings and give providers a more effective way of improving PAD screening by non-specialists, too.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.