The significance of aortoiliac atherosclerosis as assessed by Doppler ultrasound.
A simple, noninvasive method of assessing atherosclerotic aortoiliac obstruction is described using Doppler ultrasound with a concurrent electrocardiogram. The method is significantly more accurate than clinical examination. The pulse wave velocity profile at the common femoral artery is recorded with a nondirectional Doppler probe. The time delay from the R wave of the concurrent electrocardiogram to the ultrasound waveform peak and to a point half-way up the waveform upslope is measured. By evaluating the mean of ten such measurements at each point and then by taking the ratio of the former to the latter, a Proximal Damping Quotient (PDQ) may be derived. If the PDQ is greater than 1.4, significant proximal obstruction is probable. Conversely, a PDQ of less than 1.4 suggests a functionally clear aortoiliac segment. Any patient with a PDQ of less than 1.3 in whom reconstructive surgery is being correlated may thus be spared an aortogram and the affected limb may be investigated by femoral angiography alone. A low PDQ is supporting evidence of an adequate "run-in" to the distal segment when a distal arterial reconstruction is proposed. Similarly, if a femoro-femoral crossover graft is to be used, then significant aortoiliac atherosclerosis proximal to the donor femoral artery may be excluded without recourse to aortography.
D000328:Adult; D000368:Aged; D000792:Angiography; D001012:Aorta, Abdominal; D001018:Aortic Diseases / Q000175:diagnosis*; D001161:Arteriosclerosis / Q000175:diagnosis* / Q000503:physiopathology; D001775:Blood Circulation; D001783:Blood Flow Velocity; D004562:Electrocardiography; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007083:Iliac Artery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011674:Pulse; D012039:Regional Blood Flow; D014465:Ultrasonics / Q000295:instrumentation; D014463:Ultrasonography