title: The fate of extremities with flat lower calf pulse volume recordings.
abstract: The prognosis of patients with a flat (Class 5) or nearly flat (Class 4) pulse volume recording was studied in relation to the signs and symptoms of vascular disease in 517 patients. Within one year of follow up, 97.9% of 96 patients with jeopardized limbs and flat tracings required surgery, whereas 72.4% of 29 patients with no or minimal symptoms required reconstruction (p less than 0.001); 85.7% of patients with Class 4 tracings and jeopardized limbs required surgery, whereas 41.9% of those with minimal symptoms and Class 4 recordings developed need for reconstruction (p less than 0.001). The requirement for surgery Class 5 patients is significantly higher than in those with Class 4 tracings. The general trend of pulse volume recording amplitude to correlate with ankle systolic blood pressure was confirmed. One year mortality in Class 5 patients was 43.2%. The majority of patients with severely abnormal pulse volume recordings eventually come to surgical reconstruction. The timing of surgery is based on the clinical status of the jeopardized limb, not solely on the presence of a pulse volume tracing abnormality.
authors.affiliation: Department of Surgery, Albany Medical College.
authors.forename: J L
authors.initials: JL
authors.lastname: Kaufman
authors.forename: K M
authors.initials: KM
authors.lastname: Fitzgerald
authors.forename: D M
authors.initials: DM
authors.lastname: Shah
authors.forename: J D
authors.initials: JD
authors.lastname: Corson
authors.forename: R P
authors.initials: RP
authors.lastname: Leather
mesh_terms: D001794:Blood Pressure; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000503:physiopathology* / Q000601:surgery; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D011379:Prognosis; D011674:Pulse; D012086:Reoperation