Professional Practice Guide -FCSV-EN

16 Professional Practice Guide 3.3 DOPPLER ULTRASOUND In patients with a high degree of suspicion for PAD and/or a significant decrease in the ABI, the next step is Doppler ultrasound evaluation of the lower limbs. The low-cost and non-invasive technique combines ultrasound imaging and Doppler assessment, allowing evaluation of the anatomical location and nature of the lesion, characterization of atherosclerotic plaques, and precise quantification of the degree of obstruction through measurement of blood flow velocity. This technique does, however, have limitations. It is considered less optimal in patients with obesity and in those with calcified arteries. It is also less accurate for evaluation of the aortoiliac region. 3.4 ADVANCED IMAGING TESTS In patients for whom Doppler ultrasound evaluation is insufficient, or when percutaneous or surgical revascularization is being planned, imaging with intravenous contrast administration becomes necessary. Two imaging options are available: computed tomography angiography (CTA) and magnetic resonance imaging (MRI). In the case of CTA, the patient lies on an examination table that is advanced into a tunnel. A contrast agent (iodine) is injected into a vein in the arm to allow visualization of the arteries during image acquisition. 3. Evaluating Peripheral Artery Disease (PAD) Ӌ Computed tomography angiography (Angio-CT scan) Ӌ Magnetic resonance imaging (MRI) In the case of CTA, the patient lies on an examination table that is advanced into a tunnel.