Is femoral pulse palpation accurate in assessing the hemodynamic significance of aortoiliac occlusive disease?
Palpation of the common femoral artery pulse has been the mainstay in the clinical assessment of the significance of aortoiliac disease for deciding whether to perform a suprainguinal versus an infrainguinal bypass. This study was performed to assess the accuracy of clinical pulse palpation in comparison to intraarterial pressure measurements of 31 common femoral arteries in 21 patients. Pulse palpation was graded as to the presence (abnormal) or absence (normal) of hemodynamically significant aortoiliac occlusive disease while at rest. A femorobrachial index of less than 0.9 was considered hemodynamically significant. Data were analyzed by decision matrix analysis. Results demonstrated pulse palpation to be 100 percent sensitive, 54 percent specific, and 61 percent accurate. The negative predictive value of normal pulse to palpation was 100 percent, but the positive predictive value for an abnormal pulse to palpation was only 29 percent. Even though pulse palpation should remain an integral part in the clinical assessment of the peripheral vascular tree, it should be used with caution in the clinical decision-making process.
D001018:Aortic Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001794:Blood Pressure; D005069:Evaluation Studies as Topic; D005263:Femoral Artery / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007083:Iliac Artery; D010173:Palpation; D011446:Prospective Studies; D011674:Pulse