ABSTRACT
OPINION STATEMENT: Imaging modalities to detect and diagnose vascular disease have become increasingly popular in recent years, owing in large part to their availability and accessibility. The American College of Cardiology Foundation published a two-part Appropriate Use Criteria (AUC) guidance document for both peripheral vascular imaging and physiologic testing several years ago. In the years since their publication, a number of important studies have challenged previously held beliefs about appropriateness of vascular diagnostic testing. To address the ever-changing landscape, we offer a review of the current appropriate use guidelines for arterial vascular diagnostic procedures and relevant major studies published in the interim. We aim to provide a comprehensive review of appropriate arterial vascular diagnostic imaging testing for the cardiovascular clinician.
ABSTRACT
OPINION STATEMENT: The need to develop highly qualified, multidisciplinary critical limb ischemia (CLI) programs has gained significant momentum. Due to the systemic nature of the disease, patients with CLI are inherently medically complex and often present with multiple comorbidities. Successful care for these patients depends on community screening, early referral, accurate diagnosis, risk stratification, risk factor modification, invasive and non-invasive treatment strategies, and appropriate surveillance. Patients with CLI are often treated by multiple subspecialists-often lacking a unified team which could lead to inefficiencies and redundancy. Establishing an effective critical limb ischemia program relies on the joint efforts of multiple physician specialists, nurses, technicians, wound care specialists, researchers, and administrators who together form an integrated network that is easily accessible to the patient. This article will focus on the various modalities needed to build an advanced critical limb ischemia program, while addressing the challenges facing the medical community in caring for this population.
