Background

The management of acute limb ischemia is largely based on the etiology of arterial occlusion (embolic vs. thrombotic). To our knowledge, the ability of duplex scanning to differentiate embolic from thrombotic occlusion has not been previously reported.

Purpose

The purpose of the study was to determine the ability of duplex scanning to differentiate embolic from thrombotic acute arterial occlusion.

Purpose

The purpose of the study was to determine the ability of duplex scanning to differentiate embolic from thrombotic acute arterial occlusion.

Methods

We prospectively recruited 97 patients (50.3±19.7 years; 55% males) with 107 nontraumatic acute limb ischemias in native arteries. All patients underwent surgical revascularization. Preoperative duplex scan detected arterial occlusion in the following arteries: iliac (11), femoral (38), popliteal (38), infrapopliteal (3), subclavian (3), axillary (1), brachial (9) and forearm arteries (4). We measured the arterial diameters at the site of occlusion ( d _occl ) and at the corresponding contralateral healthy side ( d _contra ). The difference (Δ) between the two diameters was calculated as ( d _occl − d _contra ). Duplex scan was also used to assess the state of the arterial wall (whether healthy or atherosclerotic) and the presence of calcification or collaterals. According to surgical findings, limbs were classified into embolic (E-group=55 limbs) and thrombotic (T-group=52 limbs) groups.

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