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Brian L. Thiele, MD; Dennis F. Bandyk, MD; Robert E. Zierler, MD; D. Eugene Strandness, Jr, MD

Arch Surg. 1983;118(4):477-481.

Abstract
• The accurate localization of hemodynamically significant disease in the aortoiliac segment remains a major clinical dilemma that contributes to the less than optimal results reported for aortofemoral bypass grafting in patients with disabling lower limb claudication. We assessed the hemodynamic status of the aortoiliac segment with direct intraarterial pressure measurements obtained prior to arteriography. This served as a basis for determining the role of the femoral pulsatility index (FPI) in evaluating the hemodynamics of the aortoiliac segment. A stepwise decision making algorithm, developed from the results, enabled accurate identification of the location of the hemodynamic disturbance in 94% of the limbs studied. In 62% of the limbs, the FPI could be used, while in the remaining 38%, intra-arterial pressure measurements were used.

(Arch Surg 1983;118:477-481)

Author Affiliations
From the Peripheral Vascular Section (Dr Thiele) and Surgical Service (Drs Vandyk and Zierler), Veterans Administration Medical Center, and the Department of Surgery, University of Washington (Dr Strandness), Seattle.

Footnotes
Accepted for publication Oct 13, 1982.

Read before the Sixth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Atlanta, May 14, 1982.

Reprint requests to Surgical Service (112), Veterans Administration Medical Center, 4435 Beacon Ave S, Seattle, WA 98108 (Dr Thiele).

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