Optimiser le bilan des lésions jambières grâce à l'imagerie

In front of a vascular leg ulcer, the assessment focuses on detecting a rest or a critical ischemia, which is the diagnosis with the most severe prognosis. Measurement of ABPI, possibly supplemented by measurement of TcPO2 or toe pressure, confirm the diagnosis. Diagnosis made, it is necessary to map the lesions responsible for ischemia to plan a revascularization. This complementary assessment must be carried out as soon as possible because 'time is tissue'. Arteriography remains the standard examination but is generally not performed as a first-line due to its invasive character and is performed at the same time of the treatment. In order to guide the revascularization technique the use of echo-Doppler examination is generally the rule because of its good availability, safety, cost and good diagnostic performance, even in leg injuries. However, in complex cases, the use of an angioscanner or angio-MRI, requested in the second intention, can help the therapeutic decision.