A new non-invasive technique for assessment of superficial femoral artery obstruction

Abstract

A transcutaneous technique is described utilizing two ultrasonic Doppler‐shift flow‐velocity meters simultaneously at sites down the arterial system of the leg in patients with superficial femoral disease. The change in shape of the blood‐velocity/time wave‐form over the cardiac cycle and the pulse propagation time between the two sites are measured. The transit time and change in pulse shape are used to assess limb viability. This method is compared with two other non‐invasive techniques: whole‐limb flow measured by a strain‐gauge plethysmograph and with the systolic pressure difference between the arm and the calf. It is shown that as the pulse propagation time and the degree of damping of the blood‐velocity/time wave‐form increase, then limb perfusion decreases, and a nomogram is presented relating these parameters.

Pulsed doppler ultrasound detection of flow disturbances in arteriosclerosis

“…Woodcock and Gosling (9) have reported the use of sonograms of continuous wave Doppler ultrasound recordings to identify occlusion of the femoral artery. This method involves measurement of the arterial pulse wave velocity (or propagation time between two Doppler ultrasound transducers) and also the determination of a "pulsatility index" or "damping factor" (calculated from a Fournier analysis of the harmonics of the frequency display of an average pulse derived from a series of sonograms).…”

Clinical diagnosis by transcutaneous Doppler ultrasound

“…For patients who cannot walk, the alternative is to stimulate reactive hyperaemia after temporary ischaemia induced by a thigh pneumatic tourniquet (Hummel et al, 1978). However, Fronek, Coel and Bernstein (1978) Woodcock, Gosling and Fitzgerald (1972) who timed the propagation of the pulse along arterial segments; this allowed differentiation between various forms of arterial obstruction. Ideally this approach should be combined with the integrated multisegmental pressure measurement and Doppler flow velocity studies recommended by Fronek et al (1978), when a high level of reliability in the assessment of peripheral arterial occlusive disease might be anticipated.…”

Cerebral Blood Flow Responses to Severe Orthostatic Stress in Fit and Unfit Young and Older Adults

“…Cerebrovascular resistance index was calculated as (MAP/ CBFV) while the pulsatility index, another index of cerebral vascular resistance [21] , was calculated as [(systolic CBF velocitydiastolic CBF velocity)/mean CBF velocity]. Cerebral blood flow values acquired in the last minute of supine rest, at the end of each 4-min LBNP stage and at presyncope, as well as the concurrent resistance indices, were used for statistical comparisons.…”