Description of Doppler waveforms to detect lower extremity peripheral artery disease

Abstract

Doppler waveforms analysis is a interesting to diagnose peripheral artery disease as suggested by the international recommendations. However as mentioned in the present letter, there is a lack of consensus about the terminology that should be used.

Dear Editor

We were pleased to read the paper from Tehan et al. entitled ‘How sensitive and specific is continuous-wave Doppler for detecting peripheral arterial disease in people with and without diabetes? A cross-sectional study’. ¹ It is well known that international guidelines suggest the use of Doppler waveform analysis to detect lower extremity peripheral artery disease. In this article, the authors suggest that the use of continuous Doppler waveforms (CWDs) could be useful to detect lower extremity peripheral artery disease. We totally agree with the conclusions of the authors but a major issue is that there is no standard about the description of Doppler waveforms. ² Indeed, Tehan et al. decided to classify Doppler waveforms into two categories: multiphasic (i.e. normal) or monophasic (i.e. pathological). Previous papers have shown that there is a huge heterogeneity in the description of the Doppler waveforms among sonographers or physicians or students and even in the same country.^3–5 Nicolaides and Yao have found that similar words such as biphasic or monophasic used in different papers do not have the same graphical representation. ⁵ Therefore, we would like to invite Tehan et al. to present the arterial Doppler waveforms graphical representation that they have used in their paper in order to use it in future research studies and in clinical practice.