Hyperemic response for accurate diagnosis of arterial insufficiency
J. M. Van De Water, C. D. Indech, R. B. Indech and H. T. Randall
Monitoring of calf (or ankle) blood pressure during reactive hyperemia
after thigh arterial occlusion allows differentiation of normal from
abnormal responses and of distal (femoropopliteal [FP] system) disease from
proximal (aortoiliac [AI] disease. The hyperemic response of 106 lower
extremities representing three disease states--FP (N = 19), AI (N = 15),
and combined (AI plus FP)(N = 16)--were compared with each other and with
20 normal subjects and 36 asymptomatic diabetics. Not only were the three
disease states readily distinguished from the very similar normal subjects
and asymptomatic diabetics, but there was a highly significant difference
between FP disease and AI disease up to 150 s. This is a simple,
inexpensive, and reliable test that can be used at the bedside to determine
levels of severe disease, especially in the claudicator, who may not have a
critical stenosis under resting conditions.
