Related Experiment Video
Updated: May 13, 2025

Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Measuring Arterial Occlusion Pressure Using Pulse Wave and Continuous Wave Doppler Ultrasound and 2 Methods of Cuff
Pat R Vehrs1, Shay Richards1, Joshua Allen1
1Department of Exercise Sciences, Brigham Young University, Provo, UT, USA.
Context:
It is recommended that arterial occlusion pressure (AOP) should be measured prior to the use of blood flow restriction training. Previous studies have not compared measures of AOP when using 2 methods of cuff inflation commonly reported in the literature.
Design:
A cross-sectional observational study was used to compare the measurement of brachial artery AOP as measured using pulse wave Doppler ultrasound (PWDOP) and continuous wave Doppler ultrasound (CWDOP) devices when inflating the cuff with a research/clinical-grade Hokanson (HOK) rapid cuff inflation system and manually (MAN) with a hand pump and gauge.
Methods:
We made simultaneous measures of brachial artery AOP in 20 males and 21 females using PWDOP and CWDOP devices when using HOK and MAN cuff inflation methods. Data were analyzed with a linear mixed model analysis of variance and Bland-Altman plots.
Results:
There was not a significant main effect for the overall differences in AOP as measured using PWDOP (121.7 ± 14.7 mmHg) and CWDOP (121.3 ± 14.5 mmHg; P = .3641). There was a significant overall main effect for AOP measured using the HOK (122.7 ± 14.6 mmHg) and MAN (120.3 ± 14.6 mmHg) cuff inflation methods (P < .0001) and between males (128.2 ± 13.7 mmHg) and females (115.2 ± 12.5 mmHg; P = .0034). Bland-Altman plots revealed minimal bias and reasonable limits of agreement between PWDOP and CWDOP measures of AOP when using HOK (0.8 mmHg; 95% CI, -4.7 to 3.0 mmHg) and MAN (0.4 mmHg; 95% CI, -5.3 to 4.5 mmHg) cuff inflation methods.
Conclusions:
The cessation of an audible pulse using CWDOP is in agreement with the complete obstruction of the arterial blood flow observed using PWDOP. Although statistically significant, small differences in PWDOP and CWDOP measures of AOP when using HOK and MAN cuff inflation methods are of little practical significance. A hand-held CWDOP device and a handpump/gauge can be used to measure AOP.
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The Brachial Artery: Primary Site for Blood Pressure Measurement
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This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.

