Document Detail


ACR appropriateness criteria on recurrent symptoms following lower-extremity angioplasty.
MedLine Citation:
PMID:  19027679     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lower-extremity arteriopathy patients can be managed nonsurgically, but there is no standard algorithm for follow-up. The authors present a consensus on appropriate postangioplasty studies in the setting of claudication or a threatened limb. Physical examination with measurements of the ankle-brachial index should be the first step in patients with recurrent symptoms. When there is high clinical suspicion for a threatened limb, the patient should proceed directly to catheter angiography for possible reintervention. However, in the setting of claudication alone, segmental Doppler pressures and pulse volume recordings are the initial test of choice. Magnetic resonance angiography or ultrasound can be used in conjunction to further characterize lesions with more detail. Computed tomographic angiography may also be used to image lower-extremity vasculature but is limited by the presence of large amounts of vascular calcifications. Novel techniques, including dual-energy computed tomographic angiography and noncontrast magnetic resonance angiography, may provide clinicians with alternative approaches in patients with large amounts of vascular calcifications and renal insufficiency, respectively.
Authors:
Frank J Rybicki; Leelakrishna Nallamshetty; E Kent Yucel; Stephen R Holtzman; Richard A Baum; W Dennis Foley; Vincent B Ho; Leena Mammen; Vamsidhar R Narra; Barry Stein; Gregory L Moneta;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Radiology : JACR     Volume:  5     ISSN:  1558-349X     ISO Abbreviation:  J Am Coll Radiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101190326     Medline TA:  J Am Coll Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1176-80     Citation Subset:  IM    
Affiliation:
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. frybicki@partners.org
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MeSH Terms
Descriptor/Qualifier:
Angioplasty / adverse effects*,  standards
Humans
Intermittent Claudication / etiology*,  surgery*
Lower Extremity / blood supply*
Practice Guidelines as Topic*
Recurrence / prevention & control
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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