Duplex Ultrasound

in Vascular Diagnostics and Imaging

Applied

Type

Reinforcement

Confidence

95%

Created

Mar 20, 2026

Evidence

3 sources

Rationale

The integration incorporates the most recent major society guidelines (2022-2024) for PAD and Aortic Disease. These guidelines reinforce the primary role of Duplex Ultrasound in screening, diagnosis, and post-intervention surveillance. I expanded the DVT and DUS abbreviations as per instructions and updated the 'Guidelines' summary list to include these definitive references.

Evidence

Gornik HL, et al. 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease. Circulation. 2024. PMID: 38743805.
Verified source
PubMedDOI
Isselbacher EM, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease. Circulation. 2022. PMID: 36322642.
Verified source
PubMedDOI
Writing Committee Members, et al. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease. J Thorac Cardiovasc Surg. 2023. PMID: 37389507.
Verified source
PubMedDOI

Content Changes

* **Principle:** Combines B-mode imaging with Doppler waveform analysis to provide both anatomic and hemodynamic information.information via duplex ultrasound (DUS).
* **Applications:**
  * Carotid artery stenosis grading (using NASCET and ESVS criteria); see [[Cerebrovascular Disease|Ch. 7]] for complete grading tables and management thresholds.
  * peripheralPeripheral arterial disease (PAD) severity assessmentassessment, lesion localization, and lesionsurveillance localization.of revascularization procedures [@svs2024-j].
  * abdominalAbdominal aortic aneurysm (AAA) diameter measurementmeasurement, screening, and surveillance;surveillance [@aha2022-e] [@aha2023-writing]; see [[Aneurysmal Diseases|Ch. 4]] for screening/surveillance protocols.
  * 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)).(EVAR)) [@svs2024-j].
* **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, PAD, and AAA surveillance.surveillance [@moneta2010] [@sru2003] [@esvs2018-esvs] [@esvs2019-aaa] [@esvs2015] [@almasri2018] [@evar2019] [@aha2022-e] [@svs2024-j].
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