Arterial Duplex – Upper and Lower Extremities

Duplex ultrasonography of the upper and lower extremity arteries is performed to provide an overview of the location, extent and severity of vascular disease. The lower extremity Doppler evaluation is performed from the iliacs through the tibial vessels and extended into the foot, while the upper extremity variant can be performed from the subclavian artery to the wrist.

Sites of suspected stenosis are evaluated with Doppler measurements proximal to, within, and distal to maximum stenosis.

Duplex imaging determines the plaque length in arterial segments and patency of distal vessels. Arterial imaging will also help determine if claudication is associated with arterial disease or musculoskeletal or neuropathic reasons. A controlled trial of the effectiveness of imaging procedures suggested that the results of Duplex ultrasound were comparable to those of contrast angiography, in terms of surgical planning and outcome. (HTA 2007).


  • Evaluation or follow-up of patients with claudication, ischemic rest pain, and/or arterial ulceration
  • Assessment of patients with documented arterial disease
  • Pre-procedure assessment for planning of intervention
  • Follow-up to determine technical adequacy of surgical intervention, i.e., post angioplasty and/or stent placement
  • Follow-up of bypass grafts to detect intrinsic stenoses or progression of disease, which may threaten graft patency
  • Evaluation of aneurysm, pseudoaneurysm and arterial-venous fistula
  • Evaluation of arterial trauma
  • Absent or diminished distal or pedal pulse
  • Diabetes with peripheral circulatory disorder
  • Skin or nail infections
  • Skin color changes or ulcerations
  • Distal extremity hair loss
  • Gangrene
  • Extreme weakness or fatigue
  • Vasomotor instability
  • Numbness

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