What are the ESC/ESVS diagnostic guidelines for lower-extremity arterial disease (LEAD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Recommendations related to screening and diagnosis of lower-extremity arterial disease (LEAD) include the following:

  • ABI is indicated as a first-line noninvasive test for screening and diagnosis of lower-extremity arterial disease (LEAD) (class I recommendation; evidence level C)
  • If ankle arteries are not compressible or ABI >1.40, alternative methods (eg, toe-brachial index [TBI], Doppler waveform analysis, or pulse volume recording) are indicated (class I recommendation; evidence level C)
  • DUS is a first-line imaging modality for confirming LEAD (class I recommendation; evidence level C)
  • DUS and/or CTA and/or MRA are indicated for characterizing anatomy in LEAD and guiding optimal revascularization (class I recommendation; evidence level C)
  • Anatomic imaging data should always be analyzed in conjunction with symptoms and hemodynamic data for treatment is decided on (class I recommendation; evidence level C)
  • DUS screening for abdominal aortic aneurysm (AAA) should be considered (class IIa recommendation; evidence level C)

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