Penunjang

Penunjang

1. Duplex ultrasound (DUS) : Duplex ultrasound (DUS) is a first step in the vascular work-up for PAD screening and diagnosis, allowing a dynamic, non-invasive, radiation- and contrast-free examination. It localizes vascular lesions and quantifies their extent and severity through velocity criteria. In combination with ABI or TBI, DUS permits determining the haemodynamic relevance of arterial lesions and estimation of ABI. DUS has a sensitivity of 88% and specificity of 95% for >50% stenosis detection.
2. CT-Angiography : Another non-invasive technique is CTA, which utilizes intravenous contrast medium injection to opacify the arterial lumen and detect any change in the caliber. Assessment of the stenosis, occlusion and collateral circulation can be done using multislice thin axial cuts followed by multiplanar reconstruction. Maximum intensity projections (MIP) and volume rendering techniques (VRT) can also be used in the assessment of the vessels. 
3. MR angiography : MR angiography is a noninvasive technique that can be acquired without contrast administration, however, sometimes it can overestimate stenosis severity.
4. Digital subtraction angiography : Digital subtraction angiography is an invasive technique done percutaneously through femoral catheter insertion. It is the gold standard for assessment of stenosis, occlusion and collateral flow and can be diagnostic and therapeutic.