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. 2021 Jan 26;10(3):464.
doi: 10.3390/jcm10030464.

Comparison of the Use of Arterial Doppler Waveform Classifications in Clinical Routine to Describe Lower Limb Flow

Antoine Guilcher  1 , Damien Lanéelle  2 , Clément Hoffmann  3 , Jérôme Guillaumat  2 , Joel Constans  4 , Luc Bressollette  3 , Claire Le Hello  5 , Christian Boissier  5 , Alessandra Bura-Rivière  6 , Vincent Jaquinandi  1 , Loukman Omarjee  1 , Philippe Lacroix  7 , Gilles Pernod  8 , Fabrice Abbadie  9 , Marie Antoinette Sevestre  10 , Carine Boulon  4 , Guillaume Mahé  1
Affiliations

Comparison of the Use of Arterial Doppler Waveform Classifications in Clinical Routine to Describe Lower Limb Flow

Antoine Guilcher et al. J Clin Med. .

Abstract

Background: Characterisation of arterial Doppler waveforms is a persistent problem and a source of confusion in clinical practice. Classifications have been proposed to address the problem but their efficacy in clinical practice is unknown. The aim of the present study was to compare the efficacy of the categorisation rate of Descotes and Cathignol, Spronk et al. and the simplified Saint-Bonnet classifications.

Methods: This is a multicentre prospective study where 130 patients attending a vascular arterial ultrasound were enrolled and Doppler waveform acquisition was performed at the common femoral, the popliteal, and the distal arteries at both sides. Experienced vascular specialists categorized these waveforms according to the three classifications.

Results: of 1033 Doppler waveforms, 793 (76.8%), 943 (91.3%) and 1014 (98.2%) waveforms could be categorized using Descotes and Cathignol, Spronk et al. and the simplified Saint-Bonnet classifications, respectively. Differences in categorisation between classifications were significant (Chi squared test, p < 0.0001). Of 19 waveforms uncategorized using the simplified Saint-Bonnet classification, 58% and 84% were not categorized using the Spronk et al. and Descotes and Cathignol classifications, respectively.

Conclusions: The results of the present study suggest that the simplified Saint-Bonnet classification provides a superior categorisation rate when compared with Spronk et al. and Descotes and Cathignol classifications.

Keywords: Doppler; methods; peripheral artery disease; vascular medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The different arterial Doppler waveform classifications. Panel labelled Cathignol and Descotes classification (adapted from [23]): Type N or 0 is considered as a normal waveform. Panel labelled Spronk et al. classification (adapted from [24]): Triphasic of biphasic types are considered normal. Monophasic and poor monophasic types describe different levels of peripheral artery disease (PAD), from the least to the highest degree. Panel labelled simplified Saint-Bonnet classification: Types N and A are considered normal. Types B to E describes different levels of PAD, from the least to the highest degree.
Figure 2
Figure 2
Differences in categorization between the different classifications. Side-by-side comparison of the three classifications categorization rate. p values according to Chi squared test.
Figure 3
Figure 3
Number of normal and abnormal waveforms according to the Fontaine scale. In this case, waveforms refer to the lower-rated waveforms across both limbs according to each classification. Normal waveforms: Descotes and Cathignol type N, Spronk et al.’s triphasic and biphasic types and simplified Saint-Bonnet types N and A. Other waveforms: categorized but not normal, as defined above. NC: not categorized. * p < 0.05 compared with Fontaine grade I.
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