Pub Date : 2023-06-19DOI: 10.1177/15443167231179207
J. Agyekum, Jared Oblitey, K. Yeboah
Introduction: Peripheral arterial disease (PAD) is a common cardiovascular disorder less commonly diagnosed in female patients. Peripheral arterial disease is objectively diagnosed using the ankle-brachial index (ABI), which can be measured using the “gold standard” Doppler method or the oscillometric method. The agreement between these 2 methods is less investigated in the sub-Saharan African population. Therefore, we compared the diagnostic characteristics of the oscillometric method of measuring ABI with the Doppler method in premenopausal female patients in Ghana. Methods: The ABI was measured in non-diabetic premenopausal women suspected of having PAD using the Doppler method with an 8 MHz handheld Doppler (LifeDop 250, Summit Doppler) and an oscillometric device (Vasera 1500N, Fukuda Denshi) in 160 patients (320 legs). Peripheral arterial disease was defined as an ABI <0.90 in at least one leg. Leg symptoms were assessed using the Edinburgh claudication questionnaire. Results: Leg pain on exertion was present in 101 patients screened with similar mean ABIs in the right and left legs. The prevalence of PAD as screened by the Doppler method was 25.7% (18.9%-33.4%) and that of the oscillometric method was 32.2% (24.9%-40.3%). In comparison with the Doppler method, the accuracy of the oscillometric method was 88.2%, and the sensitivity, specificity, positive predictive value, and negative predictive value were 89.7%, 87.6%, 71.4%, and 96.1%, respectively. The overall agreement between the Doppler and oscillometric methods was high, = 0.78 (0.62-0.91), P < .001, with an intraclass correlation of 0.89 (0.87-0.92, P < .001). In receiver-operating characteristic (ROC) curve analysis, the oscillometric method showed an area under the curve of 0.925 compared with the Doppler method in the diagnosis of PAD. Conclusion: In non-diabetic premenopausal women in our study, oscillometric ABI performed acceptably in the diagnosis of PAD when compared with Doppler ABI.
{"title":"Comparison of Doppler and Oscillometric Methods of Assessing Ankle-Brachial Index in Non-diabetic Premenopausal Women in Ghana","authors":"J. Agyekum, Jared Oblitey, K. Yeboah","doi":"10.1177/15443167231179207","DOIUrl":"https://doi.org/10.1177/15443167231179207","url":null,"abstract":"Introduction: Peripheral arterial disease (PAD) is a common cardiovascular disorder less commonly diagnosed in female patients. Peripheral arterial disease is objectively diagnosed using the ankle-brachial index (ABI), which can be measured using the “gold standard” Doppler method or the oscillometric method. The agreement between these 2 methods is less investigated in the sub-Saharan African population. Therefore, we compared the diagnostic characteristics of the oscillometric method of measuring ABI with the Doppler method in premenopausal female patients in Ghana. Methods: The ABI was measured in non-diabetic premenopausal women suspected of having PAD using the Doppler method with an 8 MHz handheld Doppler (LifeDop 250, Summit Doppler) and an oscillometric device (Vasera 1500N, Fukuda Denshi) in 160 patients (320 legs). Peripheral arterial disease was defined as an ABI <0.90 in at least one leg. Leg symptoms were assessed using the Edinburgh claudication questionnaire. Results: Leg pain on exertion was present in 101 patients screened with similar mean ABIs in the right and left legs. The prevalence of PAD as screened by the Doppler method was 25.7% (18.9%-33.4%) and that of the oscillometric method was 32.2% (24.9%-40.3%). In comparison with the Doppler method, the accuracy of the oscillometric method was 88.2%, and the sensitivity, specificity, positive predictive value, and negative predictive value were 89.7%, 87.6%, 71.4%, and 96.1%, respectively. The overall agreement between the Doppler and oscillometric methods was high, = 0.78 (0.62-0.91), P < .001, with an intraclass correlation of 0.89 (0.87-0.92, P < .001). In receiver-operating characteristic (ROC) curve analysis, the oscillometric method showed an area under the curve of 0.925 compared with the Doppler method in the diagnosis of PAD. Conclusion: In non-diabetic premenopausal women in our study, oscillometric ABI performed acceptably in the diagnosis of PAD when compared with Doppler ABI.","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"132 - 139"},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49059551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/15443167231162946
R. Zierler
{"title":"Letter From the Editor","authors":"R. Zierler","doi":"10.1177/15443167231162946","DOIUrl":"https://doi.org/10.1177/15443167231162946","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"67 - 67"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42512642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-16DOI: 10.1177/15443167231175308
{"title":"Factors Predicting Outcomes in Patients with Critical Limb Ischemia After Multidisciplinary Team Treatment: A 5-year Single-Center Retrospective Review for CME Credit June 2023","authors":"","doi":"10.1177/15443167231175308","DOIUrl":"https://doi.org/10.1177/15443167231175308","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"103 - 103"},"PeriodicalIF":0.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43318023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-12DOI: 10.1177/15443167231173039
{"title":"Editor-in-Chief Announcement and Position Description","authors":"","doi":"10.1177/15443167231173039","DOIUrl":"https://doi.org/10.1177/15443167231173039","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"69 - 69"},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44914886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.1177/15443167231175309
{"title":"Persistent Sciatic Veins for CME Credit June 2023","authors":"","doi":"10.1177/15443167231175309","DOIUrl":"https://doi.org/10.1177/15443167231175309","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"105 - 105"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47960942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.1177/15443167231175306
{"title":"Measuring Carotid Intima-Media Thickness in Young Adults Born Preterm: Comparison of Manual Verses Semi-Automated B-Mode Ultrasound for CME Credit June 2023","authors":"","doi":"10.1177/15443167231175306","DOIUrl":"https://doi.org/10.1177/15443167231175306","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"102 - 102"},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43755074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-10DOI: 10.1177/15443167231175307
{"title":"Potential Utility of Hand Acceleration Time in Quantifying the Degree of Malperfusion in Patients with Suspected Hemodialysis Access-Induced Digital Ischemia for CME Credit June 2023","authors":"","doi":"10.1177/15443167231175307","DOIUrl":"https://doi.org/10.1177/15443167231175307","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"104 - 104"},"PeriodicalIF":0.0,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44490446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.1177/15443167221132270
Ramy El Jalbout, A. Flahault, Amirali Shahi, J. Bigras, A. Cloutier, J. Dubois, A. Nuyt, T. Luu
Introduction: Young adults born very preterm have increased cardiovascular risks. While intima-media thickness of the common carotid artery is an early marker of atherosclerosis in adults, the most reliable method of its measurement is not established in this population. The purpose of this study is to compare manual and semi-automated B-mode ultrasound intima-media thickness measurement techniques in adults born very preterm and full-term. Methods: Intima-media thickness was measured in adults 18 to 29 years born very preterm (<30 weeks’ gestation) or full-term (≥37 weeks’ gestation) using B-mode ultrasound. Analyses included intraclass correlation coefficient (ICC) and relationships with prematurity status, age, body mass index, and metabolic and respiratory comorbidities. Results: There were 86 preterm-born participants (58% women) and 85 full-term (56% women), mean age 23 ± 2 years. Intra-observer agreement was better using semi-automated (ICC = 0.89; 95% confidence interval (CI) = [0.86-0.91]) than manual measurement (ICC = 0.73; 95% CI = [0.65-0.79]). Measures obtained using both techniques did not detect any differences according to prematurity status, did not correlate with age, and moderately correlated with body mass index. The semi-automated technique showed higher intima-media thickness values in men vs women and overall gave higher values. Results obtained through both techniques moderately correlated with each other when looking at subgroups: preterm group ICC of 0.53, full-term group ICC of 0.62. Conclusion: Manual and semi-automated intima-media thickness measurements moderately correlate in young adults. The semi-automated technique is more reproducible. Both techniques are useful in discriminating intima-media thickness according to weight. This study identifies variance of results according to different techniques of measurements. Adherence to a single technique is recommended in young adults born prematurely. Clinical implication includes adherence to the same technique for risk stratification and for follow-up of these patients.
{"title":"Measuring Carotid Intima-Media Thickness in Young Adults Born Preterm: Comparison of Manual Versus Semi-automated B-Mode Ultrasound","authors":"Ramy El Jalbout, A. Flahault, Amirali Shahi, J. Bigras, A. Cloutier, J. Dubois, A. Nuyt, T. Luu","doi":"10.1177/15443167221132270","DOIUrl":"https://doi.org/10.1177/15443167221132270","url":null,"abstract":"Introduction: Young adults born very preterm have increased cardiovascular risks. While intima-media thickness of the common carotid artery is an early marker of atherosclerosis in adults, the most reliable method of its measurement is not established in this population. The purpose of this study is to compare manual and semi-automated B-mode ultrasound intima-media thickness measurement techniques in adults born very preterm and full-term. Methods: Intima-media thickness was measured in adults 18 to 29 years born very preterm (<30 weeks’ gestation) or full-term (≥37 weeks’ gestation) using B-mode ultrasound. Analyses included intraclass correlation coefficient (ICC) and relationships with prematurity status, age, body mass index, and metabolic and respiratory comorbidities. Results: There were 86 preterm-born participants (58% women) and 85 full-term (56% women), mean age 23 ± 2 years. Intra-observer agreement was better using semi-automated (ICC = 0.89; 95% confidence interval (CI) = [0.86-0.91]) than manual measurement (ICC = 0.73; 95% CI = [0.65-0.79]). Measures obtained using both techniques did not detect any differences according to prematurity status, did not correlate with age, and moderately correlated with body mass index. The semi-automated technique showed higher intima-media thickness values in men vs women and overall gave higher values. Results obtained through both techniques moderately correlated with each other when looking at subgroups: preterm group ICC of 0.53, full-term group ICC of 0.62. Conclusion: Manual and semi-automated intima-media thickness measurements moderately correlate in young adults. The semi-automated technique is more reproducible. Both techniques are useful in discriminating intima-media thickness according to weight. This study identifies variance of results according to different techniques of measurements. Adherence to a single technique is recommended in young adults born prematurely. Clinical implication includes adherence to the same technique for risk stratification and for follow-up of these patients.","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"76 - 85"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49001848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.1177/15443167231173037
R. Zierler
{"title":"Special Letter From the Editor to Readers of the Journal for Vascular Ultrasound and Members of the Society for Vascular Ultrasound","authors":"R. Zierler","doi":"10.1177/15443167231173037","DOIUrl":"https://doi.org/10.1177/15443167231173037","url":null,"abstract":"","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"68 - 68"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46769966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-08DOI: 10.1177/15443167221132269
Maxwell D. Gruber, Jill Sommerset, Cali Hansen-Nyholm, Beejay Feliciano, Yolanda Vea, R. Karmy-Jones
Steal phenomenon after upper extremity hemodialysis access is a clinical diagnosis and consists of signs and symptoms ranging from pain during dialysis to tissue loss. Duplex ultrasonography of the access site and limb arterial perfusion often serves as an adjunct to the diagnosis but can have limitations and there is no specific duplex measurement that indicates that an intervention will be a success. We have used hand acceleration time (HAT) to assess perfusion in a number of trauma and shock cases and hypothesized that this approach could also be beneficial in assessing patients with hemodialysis access–induced distal ischemia (HAIDI), both for identifying patients who are candidates for intervention and to measure whether the intervention will be successful. Specifically, we hypothesized that a HAT <100 ms is associated with normal hand perfusion. We performed a retrospective review of 4 patients with upper extremity arteriovenous fistulas who presented with pain and tissue loss involving the ipsilateral hand. In 2 cases, the tissue loss was not primarily due to steal (one due to skin slough from antibiotic reaction and the other due to focal calciphylaxis), and 2 patients had diffuse calcific disease of the forearm arteries. All 4 patients had antegrade flow in the forearm arteries and HAT >100 ms. One patient with soft tissue sloughing was managed with banding of the proximal fistula, and 3 had proximalization of the fistula. All 4 achieved HAT <100 ms and had resolution of symptoms. Hand acceleration time may be a valuable adjunct to determine whether intervention in the setting of hemodialysis access–induced distal ischemia HAIDI may assist with wound healing.
{"title":"Potential Utility of Hand Acceleration Time in Quantifying the Degree of Malperfusion in Patients With Suspected Hemodialysis Access–Induced Distal Ischemia","authors":"Maxwell D. Gruber, Jill Sommerset, Cali Hansen-Nyholm, Beejay Feliciano, Yolanda Vea, R. Karmy-Jones","doi":"10.1177/15443167221132269","DOIUrl":"https://doi.org/10.1177/15443167221132269","url":null,"abstract":"Steal phenomenon after upper extremity hemodialysis access is a clinical diagnosis and consists of signs and symptoms ranging from pain during dialysis to tissue loss. Duplex ultrasonography of the access site and limb arterial perfusion often serves as an adjunct to the diagnosis but can have limitations and there is no specific duplex measurement that indicates that an intervention will be a success. We have used hand acceleration time (HAT) to assess perfusion in a number of trauma and shock cases and hypothesized that this approach could also be beneficial in assessing patients with hemodialysis access–induced distal ischemia (HAIDI), both for identifying patients who are candidates for intervention and to measure whether the intervention will be successful. Specifically, we hypothesized that a HAT <100 ms is associated with normal hand perfusion. We performed a retrospective review of 4 patients with upper extremity arteriovenous fistulas who presented with pain and tissue loss involving the ipsilateral hand. In 2 cases, the tissue loss was not primarily due to steal (one due to skin slough from antibiotic reaction and the other due to focal calciphylaxis), and 2 patients had diffuse calcific disease of the forearm arteries. All 4 patients had antegrade flow in the forearm arteries and HAT >100 ms. One patient with soft tissue sloughing was managed with banding of the proximal fistula, and 3 had proximalization of the fistula. All 4 achieved HAT <100 ms and had resolution of symptoms. Hand acceleration time may be a valuable adjunct to determine whether intervention in the setting of hemodialysis access–induced distal ischemia HAIDI may assist with wound healing.","PeriodicalId":52510,"journal":{"name":"Journal for Vascular Ultrasound","volume":"47 1","pages":"93 - 96"},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45009870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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