Applied

Type

Modification

Confidence

95%

Created

Mar 19, 2026

Evidence

3 sources

Rationale

The section was updated to include the most recent major society guidelines for PAD (2024) and Aortic Disease (2022). These guidelines reinforce the role of duplex ultrasound as a primary diagnostic and surveillance tool. Abbreviations were expanded on first use (DVT) to comply with the instructions.

Content Changes

* **Principle:** Combines B-mode imaging with Doppler waveform analysis to provide both anatomic and hemodynamic information.
* **Applications:**
  * Carotid artery stenosis grading (using NASCET and ESVS criteria); see [[Cerebrovascular Disease|Ch. 7]] for complete grading tables and management thresholds.
  * peripheral arterial disease (PAD) severity assessment and lesion localization.localization [@svs2024-gornik].
  * abdominal aortic aneurysm (AAA) diameter measurement and surveillance; see [[Aneurysmal Diseases|Ch. 4]] for screening/surveillance protocols.protocols [@aha2022].
  * Venous disease: reflux assessment (valve incompetence) and deep vein thrombosis detection(DVT) (DVT).detection.
  * Post-intervention graft surveillance (e.g., after bypass surgery or endovascular aneurysm repair (EVAR)).
* **Advantages:** Portable, non-invasive, relatively inexpensive, and repeatable without radiation or nephrotoxic contrast.
* **Limitations:** Operator-dependent technique with reduced accuracy in obesity, presence of bowel gas, or extensive vascular calcification.
* **Guidelines:** Recommended as first-line imaging for carotid disease, venous disease, AAA surveillance, and AAAPAD surveillance.diagnosis [@moneta2010] [@sru2003] [@esvs2018-esvs] [@esvs2019-aaa] [@esvs2015] [@almasri2018] [@evar2019] [@aha2022] [@svs2024-gornik].