ACR Appropriateness Criteria® Lower Extremity Arterial Claudication-Imaging Assessment for Revascularization: 2022 Update

Authors

Expert Panel on Vascular Imaging
Ezana M Azene
Michael L Steigner
Ayaz Aghayev
Sarah Ahmad
Rachel E Clough
Maros Ferencik
Sandeep S Hedgire
Caitlin W Hicks
David S Kirsch
Yoo Jin Lee
Lee A Myers
Prashant Nagpal
Nicholas Osborne
Anil K Pillai
Beth Ripley
Nimarta Singh
Richard Thomas
Sanjeeva P Kalva

Publication Date

11-1-2022

Journal

Journal of the American College of Radiology

Abstract

Arterial claudication is a common manifestation of peripheral artery disease. This document focuses on necessary imaging before revascularization for claudication. Appropriate use of ultrasound, invasive arteriography, MR angiography, and CT angiography are discussed. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Keywords

Humans, Societies, Medical, Evidence-Based Medicine, Intermittent Claudication, Angiography, Peripheral Arterial Disease, Lower Extremity