Noninvasive evaluation of arterial occlusive disease

A procedure for observing blood flow during early reactive hyperemia, which uses prolonged venous occlusion following 3 min of arterial occlusion, is described. A mercury strain gauge was applied around the mid-calf and 3 tracings were simultaneously recorded during reactive hyperemia: the change in venous volume, its derivative and amplified pulse waves. The method was evaluated in animals, normal volunteers and in patients with symptoms of arterial insufficiency. This bedside procedure was found to be convenient and practical. Peak flow during reactive hyperemia was found to have an accuracy comparable to the ankle/arm pressure index in distinguishing between normal, stenotic or occluded lower extremity arterial systems. In addition, it proved more accurate than pressure measurements in diabetic patients with incompressible calcified vessels.