This paper is only available as a PDF. To read, Please Download here.
Abstract
Aortoiliac obstructive disease was assessed by Doppler spectrum analysis of blood
flow velocities in the common femoral artery measured both at rest and during reactive
hyperemia. The intraarterial femoral artery pressure measured at rest and during reactive
hyperemia served as the “gold standard” for the definition of a hemodynamically significant
aortoiliac stenosis. Our results, obtained from 93 patients (136 limbs), showed that
differences between Doppler spectra obtained from limbs with a hemodynamically significant
aortoiliac stenosis and those from limbs without were more pronounced during reactive
hyperemia than at rest. The best assessment of aortoiliac obstructive disease could
be obtained with a combination of parameters derived from Doppler spectra measured
at rest and during reactive hyperemia. With these parameters, obtained by multivariate
analysis, 85% of the limbs were diagnosed correctly compared with the gold standard.
If angiographic data were added to the gold standard, even 91% of the limbs were diagnosed
correctly. We conclude that analysis of Doppler spectra obtained noninvasively from
the common femoral artery at rest and during reactive hyperemia provides an accurate
hemodynamic assessment of the aortoiliac segment.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Unrecognized aortoiliac stenosis: a physiologic approach to the diagnosis.Arch Surg. 1971; 103: 633-638
- A systematic approach to the assessment of aortoiliac disease.Arch Surg. 1983; 118: 477-481
- Aortoiliac reconstruction in patients with combined iliac and superficial femoral arterial occlusion.Surgery. 1978; 84: 348-355
- Long-term follow-up of patients having infrainguinal bypass performed below stenotic but hemodynamically normal aortoiliac vessels.J Vasc Surg. 1987; 5: 319-328
- The importance of combined multisegmental pressure and Doppler flow velocity studies in the diagnosis of peripheral arterial occlusive disease.Surgery. 1978; 84: 840-847
- The clinician and the vascular laboratory in the diagnosis of aortoiliac stenosis.Br J Surg. 1984; 71: 302-306
- Assessment of aortoiliac disease using hemodynamic measures.Arch Surg. 1985; 120: 1050-1052
- Hemodynamic evaluation of the aortoiliac system based on pharmacologic vasodilation.Surgery. 1983; 93: 709-714
- Criteria from intra-arterial femoral artery pressure measurements combined with reactive hyperaemia to assess the aorto-iliac segment: a prospective study.Br J Surg. 1984; 71: 706-708
- Measurement of systolic femoral arterial pressure during reactive hyperemia: an estimate of aortoiliac disease.J Cardiovasc Surg (Torino). 1975; 16 (suppl): 597-602
- Direct femoral artery pressure measurement at rest and during reactive hyperemia in the evaluation of the aorto-iliac segment.J Cardiovasc Surg (Torino). 1984; 25: 395-399
- Value of the spectral broadening index in continuous-wave Doppler measurements.Med Biol Eng Comput. 1987; 25: 377-385
- Quantitative ultrasonographic studies of lower extremity flow velocity in health and disease.Circulation. 1976; 53: 957-960
- The quantitative analysis of occlusive peripheral arterial disease by a non-intrusive ultrasonic technique.Angiology. 1971; 22: 52-55
- Applications cliniques de l'examen Doppler transcutane.in: Peroneau P Velocimetric ultrasonor Doppler. INSERM, Paris1974: 213-240
- An evaluation of the hemodynamic response of the claudicating extremity to exercise.Surg Gynecol Obstet. 1964; 119: 1237-1242
- Pressure studies in arterial surgery.Eur J Vasc Surg. 1987; 1: 273-283
- Determination of the hemodynamic significance of iliac artery stenosis by noninvasive Doppler ultrasonagraphy.Surgery. 1982; 91: 419-424
- The relationship between aortoiliac hemodynamics and femoral pulsatility index.J Surg Res. 1982; 32: 228-233
- Common femoral artery Doppler waveforms: a comparison of three methods of objective analysis with direct pressure measurements.Br J Surg. 1984; 71: 486-493
- Assessment of aortoiliac stenosis by femoral artery pressure measurements and Doppler waveform analysis.Eur J Vasc Surg. 1988; 2: 35-40
- The value of Doppler blood velocity tracings in the detection of aortoiliac disease in patients with intermittent claudication.Surgery. 1976; 80: 774-778
- Ultrasonographically monitored postocclusive reactive hyperemia in the diagnosis of peripheral arterial occlusive disease.Circulation. 1973; 48: 149-152
- Some aspects of ultrasound in the diagnosis and assessment of aortoiliac disease.Am J Surg. 1980; 140: 260-265
- Relationship between Doppler pulsatility index and direct femoral pressure measurements in the diagnosis of aortoiliac occlusive disease.Ultrasound Med Biol. 1983; 9: 271-281
- Characterisation of aorto-iliac arterial stenoses in terms of pressure and flow.Cardiovasc Res. 1985; 19: 559-566
- The value of power frequency spectrum analysis in the identification of aortoiliac artery disease.J Vasc Surg. 1987; 5: 803-813
- The use of duplex scanning to predict hemodynamically significant aorto-iliac stenoses.J Vasc Surg. 1988; 7: 395-399
Article info
Publication history
Accepted:
August 2,
1990
Footnotes
☆Supported by a grant from the Dutch Heart Foundation (No. 85.101).
Identification
Copyright
© 1991 Published by Elsevier Inc.
