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Background <p>Peripheral arterial occlusive disease (PAOD) is a&#xa0;systemic high-risk condition associated with substantial morbidity and mortality that requires a precise hemodynamic vascular assessment. Recent guidelines assign color duplex ultrasonography a&#xa0;key role in the diagnostics, treatment planning and follow-up of PAOD.</p> Objective <p>This article aims to characterize color duplex ultrasonography as a&#xa0;central, dynamic tool in PAOD management and to delineate the limitations of a&#xa0;purely morphological assessment based on triphasic flow patterns.</p> Methods <p>A&#xa0;structured, segmental examination protocol of the lower limb arteries is presented, including standardized stenosis grading using peak systolic velocity (PSV), end diastolic velocity (EDV) and the peak velocity ratio, together with context-dependent interpretation of Doppler waveforms. Particular emphasis is placed on peripheral resistance, arterial compliance, collateralization and clinical presentation.</p> Results <p>Color duplex ultrasonography achieves sensitivity and specificity close to digital subtraction angiography, is noninvasive, widely available and enables dynamic assessment of the hemodynamic relevance of lesions. Triphasicity alone is shown to be an unreliable marker of normality; polyphasic, high-output monophasic and post-stenotic/post-occlusive patterns can only be correctly interpreted within the clinical and hemodynamic context.</p> Conclusion <p>Color duplex ultrasonography acts as a&#xa0;hub for the diagnostics, interventional planning and long-term surveillance in PAOD. Standardized protocols, quantitative reports with clear treatment recommendations and integration into training curricula enable duplex ultrasonography to function as a&#xa0;point-of-care modality that protects patients while efficiently using resources in vascular medicine.</p>

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Alles triphasisch oder was? Gedanken zur Ultraschalldiagnostik in der pAVK

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • M. Beck,
  • S. Krishnabhakdi,
  • G. Meimarakis

摘要

Background

Peripheral arterial occlusive disease (PAOD) is a systemic high-risk condition associated with substantial morbidity and mortality that requires a precise hemodynamic vascular assessment. Recent guidelines assign color duplex ultrasonography a key role in the diagnostics, treatment planning and follow-up of PAOD.

Objective

This article aims to characterize color duplex ultrasonography as a central, dynamic tool in PAOD management and to delineate the limitations of a purely morphological assessment based on triphasic flow patterns.

Methods

A structured, segmental examination protocol of the lower limb arteries is presented, including standardized stenosis grading using peak systolic velocity (PSV), end diastolic velocity (EDV) and the peak velocity ratio, together with context-dependent interpretation of Doppler waveforms. Particular emphasis is placed on peripheral resistance, arterial compliance, collateralization and clinical presentation.

Results

Color duplex ultrasonography achieves sensitivity and specificity close to digital subtraction angiography, is noninvasive, widely available and enables dynamic assessment of the hemodynamic relevance of lesions. Triphasicity alone is shown to be an unreliable marker of normality; polyphasic, high-output monophasic and post-stenotic/post-occlusive patterns can only be correctly interpreted within the clinical and hemodynamic context.

Conclusion

Color duplex ultrasonography acts as a hub for the diagnostics, interventional planning and long-term surveillance in PAOD. Standardized protocols, quantitative reports with clear treatment recommendations and integration into training curricula enable duplex ultrasonography to function as a point-of-care modality that protects patients while efficiently using resources in vascular medicine.