Guía para el estudio no invasivo de la isquemia crónica de los miembros inferiores

Abstract

Once again, from the Vascular Diagnosis Chapter of the Spanish Society of Angiology and Vascular Surgery, we propose to update a diagnostic guide. Specifically, the Lower Limb Ischemia Study Guide. We believe that the elaboration, diffusion, and use of guides of all kinds will allow a greater homogenization in the use and diffusion of the diagnostic techniques that we use in our daily work. Homogenization will allow greater reliability and prestige in these explorations.On the other hand, the nature of diagnostic guides requires much less renewal than other types of guides and documents: the examinations that make up our reason for being do not usually vary profoundly over time. Now, it is true that the explanations can be given in another way and complement the existing ones, which are by no means obsolete. It is in this spirit that we have approached the making of this update. The previous guideline published in 2009 has been fully respected. Due to its importance and its role as a cornerstone in the study of lower limb ischemia, we have rewritten the chapter dedicated to the study with arterial Doppler ultrasound of the lower limbs, although always with a complementary vision, not exclusive, to what was already published so many years ago. The rest of the guide exposes three emerging explorations, not previously treated, since they hardly existed, which may represent an advance, an improvement, if possible, in the arterial study of ischemic extremities. It deals with pedal acceleration time, a high topic, with the determination of transcutaneous oxygen pressure, so important in the ischemic pathology of diabetics, and, finally, with perfusion angiography, an emerging diagnostic technique with infinite possibilities, many of them not even studied.To carry out this work we have turned to proven professionals in each treated section. We believe that the guide will help to better carry out our daily explorations in ischemia of the lower limbs.