Critical analysis of methods for assessing regional blood flow and their reliability in clinical medicine

The advantages and inadequacies of the currently available techniques to measure regional blood flow in the lower limbs are being reviewed. Thermodilution technique and local 133xenon washout technique have the advantage of allowing determination of blood flow during exercise, while venous occlusion plethysmography and pulsed-Doppler duplex ultrasonography only allow determination of blood flow at rest. Overall, measurements of lower limb blood flow are not highly reproducible by any technique, and the variability in measurements of regional blood flow should lead to careful interpretation of derived parameters such as vascular conductance and resistance. Determination of vascular input impedance by Fourier analysis of pressure data, recorded with high fidelity catheter, and flow velocity measurements obtained transcutaneously by Doppler ultrasonography, may offer a more accurate quantitative analysis of the characteristics of the lower limb vascular system.