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Related Experiment Videos

Patient and operation selectivity. The peripheral vascular laboratory.

J M Van De Water, E D Laska, W V Ciniero

    Annals of Surgery
    |February 1, 1979
    PubMed
    Summary

    Vascular laboratory data improves patient selection for lower extremity peripheral arterial disease interventions. Objective criteria using Doppler and plethysmography reduce unnecessary angiograms and operations.

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    Area of Science:

    • Vascular Surgery
    • Diagnostic Imaging
    • Physiology

    Background:

    • Peripheral arterial disease (PAD) of the lower extremities significantly impacts patient mobility and quality of life.
    • Accurate diagnosis and patient selection are crucial for effective treatment of PAD.
    • Traditional diagnostic methods may lead to suboptimal patient stratification and resource utilization.

    Purpose of the Study:

    • To establish objective criteria for diagnosing arterial insufficiency in lower extremity PAD.
    • To improve patient and operation selectivity for interventions targeting femoropopliteal and aortoiliac disease.
    • To reduce the ratio of diagnostic angiograms to surgical procedures.

    Main Methods:

    • Utilized segmental pressure measurements with an ultrasonic Doppler device.

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  • Approximated limb blood flow using a calibrated plethysmograph to measure pulsatile volume change rate.
  • Employed a two-cuff technique to establish resistance indices for differentiating disease locations.

    • Main Results:

    • Objective criteria for arterial insufficiency were successfully established.
    • Resistance indices effectively distinguished between femoropopliteal and aortoiliac disease.
    • The ratio of angiograms to femoropopliteal and aortoiliac operations decreased from approximately 3:1 to 1:1.

    Conclusions:

    • The integration of vascular laboratory data enhances diagnostic accuracy in lower extremity PAD.
    • Objective criteria derived from non-invasive vascular testing improve patient and operation selectivity.
    • This approach leads to a significant reduction in the need for diagnostic angiography prior to surgical intervention.