Peripheral artery disease PAD with atrial fibrillation, ultrasound, color and spectral Doppler

In a patient with Atrial Fibrillation (AFib), diabetic foot, and diffuse peripheral artery disease (PAD) mainly involving the anterior tibial artery (ATA), posterior tibial artery (PTA), and dorsalis pedis artery (DPA), ultrasound, color Doppler, and spectral Doppler imaging reveal critical findings. B-mode ultrasound shows significant arterial wall calcifications and increased intima-media thickness, particularly in smaller arteries like the ATA, DPA, and PTA. Color Doppler imaging displays irregular pulsatile flow due to AFib, with good flow in larger arteries like the superficial femoral artery (SFA) and popliteal artery.

Spectral Doppler imaging highlights irregular waveforms from AFib, with the SFA and popliteal arteries maintaining normal flow patterns and peak systolic velocities (PSV). However, the ATA, DPA, and PTA exhibit a tardus parvus waveform, indicating significant hemodynamic alterations from PAD and diabetic foot. These findings emphasize the need for comprehensive management of AFib, diabetic foot, and PAD, including optimizing anticoagulation, glucose control, foot care, and potential revascularization, to improve patient outcomes.