Lower Extremity Arterial Mapping: Duplex Ultrasound as an Alternative to Arteriography Prior to Femoral, Popliteal, and Infrapopliteal Reconstructions

In this chapter, our clinical experience with procedural duplex ultrasound used in over 3000 lower extremity open and endovascular arterial revascularization procedures is reviewed. The topics discussed include goals of preoperative duplex ultrasound arterial mapping (DUAM) for revascularization decision-making, detailed DUAM protocols, and comparison of DUAM with other imaging modalities such as contrast arteriography (XRA), computed tomographic arteriography (CTA), and magnetic resonance angiography (MRA). The learning curve for duplex arterial testing is discussed as well as the limitations and pitfalls of this diagnostic technique including necessary components to be followed during the training phase for replacing other imaging modalities with DUAM.