Pattern of Vascular Insufficiency on Ultrasound Colour Doppler and Computed Tomographic Angiography in Patients with Diabetic Foot and Its Clinical OutcomeAbhinav Seth2, Ashok Kumar Attri1, Hanish Kataria1*, Suman Kochhar3 and Navdeep Kaur3
- *Corresponding Author:
- Hanish Kataria
Department of General surgery
Government Medical College and Hospital
E-mail: [email protected]
Received date: July 25, 2017; Accepted date: August 03, 2017; Published date: August 07, 2017
Citation: Seth A, Attri AK, Kataria H, Kochhar S, Kaur N (2017) Pattern of Vascular Insufficiency on Ultrasound Colour Doppler and Computed Tomographic Angiography in Patients with Diabetic Foot and Its Clinical Outcome. OMICS J Radiol 6:269. doi: 10.4172/2167-7964.1000269
Copyright: © 2017 Kataria H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Purpose: To study the pattern of vascular insufficiency in patients with Diabetic foot using Ultrasound Color Doppler (UCD) and Computerized Tomographic (CTA) Angiography and determine its association with clinical outcome.
Material and methods: This prospective study was conducted at tertiary care institute recruiting patients >18 years of age with diabetic foot having serum creatinine <1.2 mg/dl and blood urea <40 mg/dl. Diabetic foot patients who have previously undergone revascularization surgery were excluded from the study. Ultrasound parameters like color, flow, calibre, plaque, peak systolic velocity, pulsatility index, resistance index was studied in lower limb vessels and CTA was deployed to know the exact level and extent level of occlusion, calcification and presence of collaterals. Clinical outcome was studied in terms of admissions, minor and major amputations and mortality.
Results: There were 65 patients (130 limbs; mean age: 58.49 ± 11.04 years) with male predilection (83.08 %). On UCD, the above knee arteries had predominantly good color and triphasic flow while broadening of the spectrum and monophasic flow was seen in below knee vessels. Dorsalis pedis artery had the lowest peak systolic velocity (58.44 ± 39.59 cm/s) and resistance index (0.82 ± 0.31). Atheromatous plaques were predominant in all vessels. On CTA, occlusion was seen more in the posterior tibial artery (n=40/130) while calcification was predominant in the femoral artery (n=59/130). Collaterals were present in 36.9% limbs. On logistic regression, low resistance index and biphasic flow of dorsalis pedis artery on UCD and calcification in the peroneal artery CTA could predict high rate of minor amputations.
Conclusion: Involvement of infrapopliteal vessels especially the involvement of dorsalis pedis and common peroneal artery could have a bearing on the rate of minor amputations.