Assessment of a standard exercise test in peripheral arterial disease

A recently proposed standard exercise procedure for the assessment of peripheral arterial disease has been tested in patients with unilateral intermittent claudication. The immediate post-exercise fall in systolic ankle pressure after a 1 minute walk at 4 km/h on a 10% slope has been compared with the results from the contralateral and control limbs. The test was acceptable to the patients and easy to perform but has not in this study proven sensitive enough, as described, to detect asymptomatic (but angiographically verified) arterial lesions. The test is found valuable, however, especially in patients with inconclusive resting pressure recordings i.e. with an ankle to brachial pressure index close to 0.9. A pressure drop of 30% or more in this group of patients seems to indicate functionally important arterial disease.