Duplex Ultrasound

in Vascular Diagnostics and Imaging

Applied

Type

Modification

Confidence

92%

Created

Apr 14, 2026

Evidence

1 source

Rationale

The stale Wanhainen A, et al citation in the Guidelines bullet was replaced with ESVS, which is the directly superseding 2024 ESVS guideline covering the same recommendation for duplex ultrasound as first-line imaging in AAA surveillance. No other content changes were required as the new guideline supports the same claim without introducing materially different information for this section.

Evidence

ESVS. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. Eur J Vasc Endovasc Surg. 2024. PMID: 38307694. DOI: 10.1016/j.ejvs.2023.11.002.
Verified source
PubMedDOI

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 [@svs2024-gornik].
  * abdominal aortic aneurysm (AAA) diameter measurement and surveillance; see [[Aneurysmal Diseases|Ch. 4]] for screening/surveillance protocols [@aha2022].
  * Venous disease: reflux assessment (valve incompetence) and deep vein thrombosis (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 PAD diagnosis [@moneta2010] [@sru2003] [@esvs2018-esvs] [@esvs2019-aaa][@esvs2024-editors] [@esvs2015] [@almasri2018] [@evar2019] [@aha2022] [@svs2024-gornik].

Reviewer Notes

Approved after replacement-first stale-guideline regeneration review. Clean same-family replacement of stale guideline citation with the known 2024 ESVS AAA superseding guideline.

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