TY - JOUR
T1 - ACR Appropriateness Criteria® Workup of Noncerebral Systemic Arterial Embolic Source
AU - Expert Panels on Vascular Imaging and Cardiac Imaging
AU - Parenti, Vincent G.
AU - Vijay, Kanupriya
AU - Maroules, Christopher D.
AU - Majdalany, Bill S.
AU - Koweek, Lynne M.
AU - Khaja, Minhajuddin S.
AU - Ghoshhajra, Brian B.
AU - Agarwal, Prachi P.
AU - Contrella, Benjamin N.
AU - Keefe, Nicole A.
AU - Lo, Bruce M.
AU - Malik, Sachin B.
AU - Surasi, Devaki Shilpa
AU - Waite, Kathleen
AU - Williamson, Eric E.
AU - Abbara, Suhny
AU - Dill, Karin E.
N1 - Publisher Copyright:
© 2023 American College of Radiology
PY - 2023/5
Y1 - 2023/5
N2 - Noncerebral systemic arterial embolism, which can originate from cardiac and noncardiac sources, is an important cause of patient morbidity and mortality. When an embolic source dislodges, the resulting embolus can occlude a variety of peripheral and visceral arteries causing ischemia. Characteristic locations for noncerebral arterial occlusion include the upper extremities, abdominal viscera, and lower extremities. Ischemia in these regions can progress to tissue infarction resulting in limb amputation, bowel resection, or nephrectomy. Determining the source of arterial embolism is essential in order to direct treatment decisions. This document reviews the appropriateness category of various imaging procedures available to determine the source of the arterial embolism. The variants included in this document are known arterial occlusion in the upper extremity, lower extremity, mesentery, kidneys, and multiorgan distribution that are suspected to be of embolic etiology. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - Noncerebral systemic arterial embolism, which can originate from cardiac and noncardiac sources, is an important cause of patient morbidity and mortality. When an embolic source dislodges, the resulting embolus can occlude a variety of peripheral and visceral arteries causing ischemia. Characteristic locations for noncerebral arterial occlusion include the upper extremities, abdominal viscera, and lower extremities. Ischemia in these regions can progress to tissue infarction resulting in limb amputation, bowel resection, or nephrectomy. Determining the source of arterial embolism is essential in order to direct treatment decisions. This document reviews the appropriateness category of various imaging procedures available to determine the source of the arterial embolism. The variants included in this document are known arterial occlusion in the upper extremity, lower extremity, mesentery, kidneys, and multiorgan distribution that are suspected to be of embolic etiology. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
KW - Appropriate Use Criteria
KW - Appropriateness Criteria
KW - AUC
KW - Lower extremity arterial embolism
KW - Mesenteric arterial embolism
KW - Noncerebral systemic arterial embolism
KW - Renal infarct
KW - Upper extremity arterial embolism
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U2 - 10.1016/j.jacr.2023.02.005
DO - 10.1016/j.jacr.2023.02.005
M3 - Article
C2 - 37236749
AN - SCOPUS:85160380857
SN - 1546-1440
VL - 20
SP - S285-S300
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 5
ER -