Femoral artery pulse rise time: an objective test for aorto-iliac disease.
A method is described for assessing stenosis in the aorto-iliac arterial segment using a hand-held variable capacitance pressure transducer to take objective measurements from the common femoral pulse. The aorto-iliac segments were studied in 51 arteriopaths and the common femoral pulse rise time derived. The patients also underwent an independent clinical examination. The rise time results from 88 common femoral pulses were compared with subsequent arteriographic assessment of the aorto-iliac segments, and in 67 cases with direct intra-arterial pressure measurements from the common femoral artery. A highly significant correlation coefficient was found between the common femoral pulse rise time and the degree of aorto-iliac stenosis on the arteriogram (r = 0.80). Similarly, there was good correlation between pulse rise time and the direct common femoral/radial pressure ratios (r = -0.82). The results were analysed in terms of sensitivity, specificity and diagnostic accuracy for determining greater or less than 50% stenosis on the arteriogram. Using a pulse rise time of 200 ms a sensitivity of 97%, specificity of 93% and diagnostic accuracy of 94% were obtained. This was significantly better than clinical examination which gave a diagnostic accuracy of 83% (X2 = 5.57, P less than 0.02). The results suggest that this non-invasive method of objective pulse assessment gives superior accuracy for diagnosing aorto-iliac stenotic disease. The ease of use and relative simplicity of the apparatus are advantages over more complex non-invasive techniques employing microprocessors in the analysis of blood velocity.
D000328:Adult; D001018:Aortic Diseases / Q000175:diagnosis*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D005260:Female; D005263:Femoral Artery / Q000502:physiology*; D006801:Humans; D007083:Iliac Artery; D008297:Male; D011446:Prospective Studies; D011674:Pulse; D014160:Transducers, Pressure