Indirect systolic pressures and pulse waves in arterial occlusive disease of the lower extremities. Circulation

Measurements were carried out in 146 limbs with angiographically documented arterial occlusive disease (AOD) and in 85 limbs without AOD. Ankle systolic pressure (AP) was equal to or higher than brachial systolic pressure in limbs without AOD. It was below 82 % of the brachial in all limbs with complete occlusion, usually below 50% in those with multiple occlusions, and above 50 % in limbs with single block. AP was below normal in 19 of 25 limbs with severe and in five of nine with mild stenosis. All limbs with complete occlusion and 14 of 16 with stenosis had abnonnal pressures in the thigh. The foot-to-peak time (CT) and the width of pulse waves at half amplitude (WD) were related to heart rate in normal limbs. Considering the heart rate, the majority of limbs with AOD had abnormally prolonged CT and WD. Normal pressures and pulse waves were found together in only two limbs with stenosis and symptoms. The findings indicate that pressures and pulse waves provide a sensitive method for diagnosis and follow-up of patients with AOD. Additional Indexing Words: Ankle systolic blood pressure Pedal pulse waves T-high systolic blood pressure Popliteal pulse waves Crest time Peripheral vascular disease Width of pulse waves Arterial stenosis Intermittent claudication SEVERE ARTERIAL NARROWING and arterial occlusion both result in dimin-ished mean pressure and in decreased ampli-tude of the pressure wave distal to the lesion. Although diastolic pressure distal to arterial stenosis does not fall until the narrowing is severe, systolic pressure decreases with lesser degrees of narrowing. ' Systolic pressure has been known to be diminished in the limbs of patients with arterial occlusive disease (AOD).2, 3 In 1956 Gaskell4 found that it was as sensitive an index of the occlusive process as the measurement of blood flow during reactive hyperemia. More recently, Strandness and co-workers`10 successfull