Accuracy of duplex ultrasound in peripheral artery disease: a systematic review and meta-analysis

Accuracy of duplex ultrasound in peripheral artery disease: a systematic review and meta-analysis

Abstract Lower limb peripheral artery disease (PAD) is highly prevalent. Current guidelines recommend duplex ultrasound (DUS) with spectral analysis for diagnosis. This systematic review and meta-analysis assessed the diagnostic accuracy of DUS in symptomatic PAD patients. We searched electronic dat...

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Bibliographic Details
Main Authors: Silfayner Victor Mathias Dias, Ronald Luiz Gomes Flumignan, Nelson Carvas Junior, Wagner Iared
Format: Article
Language:English
Published: Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV) 2025-02-01
Series:Jornal Vascular Brasileiro
Subjects:
arterial occlusive diseases
diagnostic imaging
lower extremity
peripheral vascular diseases
ultrasonography
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492025000100403&lng=en&tlng=en
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Summary:Abstract Lower limb peripheral artery disease (PAD) is highly prevalent. Current guidelines recommend duplex ultrasound (DUS) with spectral analysis for diagnosis. This systematic review and meta-analysis assessed the diagnostic accuracy of DUS in symptomatic PAD patients. We searched electronic databases for studies comparing DUS and arteriography. Arteries were analyzed individually and grouped into segments (aorto-common femoral, femoropopliteal, below the knee, and the entire lower limb). The meta-analysis estimated sensitivity, specificity, likelihood, and diagnostic odds ratios (DOR). Fifteen studies were included, analyzing 9,067 arteries. DUS accuracy for symptomatic PAD was 0.86 (95% CI 0.81-0.90) for sensitivity and 0.95 (95% CI 0.78-0.97) for specificity. The best results were observed for the femoropopliteal segment: sensitivity 0.86 (95% CI 0.80-0.90), specificity 0.95 (95% CI 0.93-0.97). The poorest performance was observed for the below-the-knee segment: sensitivity 0.78 (95% CI 0.60-0.89), specificity 0.92 (95% CI 0.78-0.97). Most studies had high and unclear risk of bias. There is significant heterogeneity in results, with a limited number of primary studies for each arterial segment, especially for the below-the-knee segment.
ISSN:1677-7301

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