SIR 2024
Arterial Interventions and Peripheral Arterial Disease (PAD)
Shakthi Kumaran Ramasamy, MD (he/him/his)
Postdoctoral Research Fellow
Stanford University School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Jill Sommerset, RVT, FSVU
Technical Director
Advanced Vascular Centers
Disclosure information not submitted.
Mary Costantino, MD, FSIR (she/her/hers)
Medical Director
Advanced Vascular Centers
Disclosure information not submitted.
Pedal Acceleration Time (PAT) is a non-invasive, cost-effective method to assess peripheral arterial disease (PAD) severity. This systematic review aims to evaluate the accuracy of PAT in diagnosing and monitoring PAD.
Materials and methods:
PRISMA guidelines was followed for the design and execution of this systematic review. A comprehensive literature search of PubMed, MEDLINE, Embase and Cochrane databases was performed for studies published from 2000 to 2022. The search used the MeSH or EMTREE terms with common keywords. The search strategy was confined to English language. Articles found through the search were first sorted for relevancy based on titles and abstracts after duplicate reports were excluded. Only research articles were included. Case reports and conference abstracts were excluded. Studies that assessed the diagnostic accuracy of PAT compared to standard methods such as ankle-brachial index (ABI), toe-brachial index (TBI), treadmill testing, or angiography were included. The pooled sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAT was calculated.
Results:
The initial search yielded 238 studies, of which 13 met the inclusion criteria. The initial search yielded 238 articles, of which 13 were identified. The pooled sensitivity and specificity of PAT for diagnosing PAD were 89.33% (95% CI: 75-92%) and 80.33% (95% Cl: 75-90%), respectively. The PPV and NPV were 87.5% (95% Cl: 81-95%) and 79.5% (95% Cl: 59-83%), respectively. Furthermore, PAT showed good correlation with traditional methods of PAD diagnosis, including ABI and TBI.
Conclusion: Pedal Acceleration Time (PAT) is a reliable and accurate non-invasive method for assessing the severity of peripheral arterial disease (PAD). Its diagnostic accuracy is comparable to traditional methods such as ABI and treadmill testing. PAT can be used as a useful tool in both diagnosing and monitoring PAD, particularly in patients with diabetes or chronic kidney disease, where ABl may be less reliable.