[Peripheral arteriosclerosis. Early diagnosis]

Pain ist not the major early symptom of peripheral vascular disease; often there is no pain at all or only with extreme physical load. Other frequently described symptoms are not characteristic. Thus even the most careful anamnesis is not entirely reliable. The simplest and quickest diagnosis is by the Doppler Ultrasonic method. The reactive hyperemia values obtained by venous occlusion plethysmography and tissue clearance with 133Xenon are also valuable in the diagnosis of beginning peripheral blood flow disturbances. Here the pulse curve analysis of the linear blood flow deserves special mention, important parameters being the peak-flow, the catacrote areal index, the peak delay, and the sum of pulse peak and pulse peak delay. The evaluation of cut-off values allows in a simple way to differentiate between normal, beginning pathological and clearly pathological conditions. However B-scanning and digital subtraction angiography will possibly be valuable supplementary procedures in future.