US Duplex Doppler Lower Extremity US duplex Doppler can identify the typical corkscrew collateral vessels in the walls of the lower-extremity vessels in patients with thromboangiitis obliterans [35]. US Intravascular Lower Extremity There is no relevant literature regarding the use of IVUS in the evaluation of lower-extremity inflammatory vasculitides. Variant 4: Suspected or known dissection or connective tissue lower-extremity vascular diseases. Initial imaging. CTA Lower Extremity CTA is highly recommended in the workup of MS, LDS, and vascular EDS, as it offers comprehensive whole- body imaging and high spatial resolution in a single study. This allows for evaluation of the entire vascular system and identification of typical musculoskeletal malformations that may assist in the initial diagnosis of a heritable connective tissue disease [1,3,4]. CTA is valuable for defining the true and false lumen and can be used for longitudinal follow-up. Although the initial diagnosis of these diseases is most commonly made in the pediatric population, this document addresses imaging in adults (18 years of age and older) only. Because of the high risk of vascular complications inherent to LDS and MS, CTA surveillance is recommended at least every 1 year [3] and 2 years [1], respectively. MRA Lower Extremity MRA has been suggested for evaluation of the lower extremities in patients with connective tissue disorders, such as MS, LDS, and vascular EDS. However, the lower spatial resolution inherent to MRA limits the evaluation of small arterial branches [1,2,36] compared to CTA. Nonatherosclerotic Peripheral Arterial Disease Arteriography Lower Extremity Given its invasive nature, the use of selective arteriography should be avoided in patients with congenitally weakened vessels (eg, collagen vascular diseases, such as vascular EDS) where the risk of catastrophic vascular perforation is high [1,4].
Nonatherosclerotic Peripheral Arterial Disease. US Duplex Doppler Lower Extremity US duplex Doppler can identify the typical corkscrew collateral vessels in the walls of the lower-extremity vessels in patients with thromboangiitis obliterans [35]. US Intravascular Lower Extremity There is no relevant literature regarding the use of IVUS in the evaluation of lower-extremity inflammatory vasculitides. Variant 4: Suspected or known dissection or connective tissue lower-extremity vascular diseases. Initial imaging. CTA Lower Extremity CTA is highly recommended in the workup of MS, LDS, and vascular EDS, as it offers comprehensive whole- body imaging and high spatial resolution in a single study. This allows for evaluation of the entire vascular system and identification of typical musculoskeletal malformations that may assist in the initial diagnosis of a heritable connective tissue disease [1,3,4]. CTA is valuable for defining the true and false lumen and can be used for longitudinal follow-up. Although the initial diagnosis of these diseases is most commonly made in the pediatric population, this document addresses imaging in adults (18 years of age and older) only. Because of the high risk of vascular complications inherent to LDS and MS, CTA surveillance is recommended at least every 1 year [3] and 2 years [1], respectively. MRA Lower Extremity MRA has been suggested for evaluation of the lower extremities in patients with connective tissue disorders, such as MS, LDS, and vascular EDS. However, the lower spatial resolution inherent to MRA limits the evaluation of small arterial branches [1,2,36] compared to CTA. Nonatherosclerotic Peripheral Arterial Disease Arteriography Lower Extremity Given its invasive nature, the use of selective arteriography should be avoided in patients with congenitally weakened vessels (eg, collagen vascular diseases, such as vascular EDS) where the risk of catastrophic vascular perforation is high [1,4].