Ultrasound-based Calcium Score for the Identification of No-Option CLTI

Background

Diabetic patients, and specifically those with associated renal failure, are contributing to a snowball of patients with very complex calcification patterns at the level of the foot. In 2021, Ferraresi et al published a paper on a proposed scoring system for early identification of patients at risk for reinterventions (both vascular and podiatric). The score was based on 2 projection X-rays of the foot, and in essence measures vascular calcium tracks on such X-rays.  

The more extensive the disease, the higher the risk of bad results overall. Sadly, the calcium of the vessels and the bones of the foot can give variable information, so we have decided to implement the knowledge that derived from this valuable scientific research.

Delving Deeper

We have been gathering ultrasound data prospectively to correlate and validate the scoring system against the Ferraresi X-ray-based proposal. We’re using variables like shadowing, color skipping, length, and pedal-acceleration time. Once all the data are validated, we will perform statistical analysis to render its validity.

Take-home Messages

Ultrasonography is an unidentified tool in the contemporary management of peripheral arterial disease. Novel scoring systems like the ultrasound medial artery calcification (uMAC) score can be very useful when personalizing the care of critical limb-threatening ischemia patients.