Doppler waveform analysis in evaluation of occlusive arterial disease in the lower limb: comparison with distal blood pressure measurement and arteriography.
Three Doppler waveform parameters were related to ankle/brachial systolic pressure (A/B) index and angiography in 75 patients with lower limb arterial occlusive disease (AOD). Doppler signals were obtained from ankle arteries, and following spectral analysis pulse rise time (PRT), systolic width (SW) and pulsatility index (PI) were calculated. All three waveform parameters were significantly correlated with A/B index, and a 20% reduction could be predicted with an accuracy of 93 to 80% (corrected for chance, kappa, 81 to 52%). A significant correlation was also found between the three Doppler parameters and the angiographic assessment, i.e. the non-diseased, single- and multisegmentally diseased limbs, however, the accuracy in diagnosing angiographic stenoses was not as good as when pressure measurement was used for reference. Thirteen of the patients had high ankle pressures despite significant angiographic stenoses, and generally the Doppler examination was normal in these cases. Considering the waveform parameters individually, PRT and SW demonstrated almost identical results when compared to pressure measurement as well as angiography, whereas PI seemed clearly inferior. It is concluded that simple Doppler waveform parameters may accurately predict the haemodynamic significance of proximal AOD.
Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Denmark.
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P
Bagi
H
H
Sillesen
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K
Bitsch
H J
HJ
Hansen
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014465:Ultrasonics; D014463:Ultrasonography