Do not request a Duplex scan as a first level test for lower limb arterial disease, in patients that are asymptomatic or with mild claudication. Measure instead the Ankle Brachial Index (ABI).
Duplex scan is often requested for paresthesias with palpable distal pulses. ABI measurement is adequate to diagnose arterial disease and start treatment. If the symptoms are severe the patient can be sent to the vascular surgeon. Following this recommendation would eliminate at least 25% of all Duplex scans performed.
1. Society for Vascular Surgery Lower Extremity Guidelines Writing Group: Conte MS, Pomposelli FB, Clair DG, Geraghty PJ, McKinsey JF, et al. Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: management of asymptomatic disease and claudication. J Vasc Surg 2015; 61(3 Suppl): 2S-41S.
2. Casati G, Panella M, Di Stanislao F, Vichi MC, Morosini P. Gestione per processi professionali e percorsi assistenziali. Progetto Formazione Qualità ISS, ARM, MS. Manuale 1, marzo 2005.
3. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, HarrisKA, Fowkes FG on behalf of the TASC II WorkingGroup: Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J VascEndovasc Surg 2007; 1: 1-75.
Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.