A simplified method for evaluating peripheral arterial occlusive disease in a clinical vascular laboratory

A relatively simple, inexpensive, and accurate procedure for the vascular laboratory evaluation of patients with suspected peripheral arterial occlusive disease is described. This method was evaluated in a series of 110 limbs in 58 patients seen in the Vascular Laboratory at the Worcester City Hospital. All patients were evaluated clinically and angiographically as well, to provide additional standards for evaluation. The method described was 100% accurate in predicting the presence or absence of significant occlusive disease, and over 90% accurate in defining the location of the major occlusive process. The method utilizes a combination of two well-established measurements--ankle systolic pressure and ankle pulse wave amplitude--as a screening method for determining the presence or absence of significant occlusive disease. Only patients with abnormal findings are tested further, resulting in a considerable savings in time and expense in the clinical vascular laboratory. The method may also prove valuable for following patients with known vascular disease for evidence of progression and for evaluating the effectiveness of various reconstructive procedures. Other methods and instruments may be adapted utilizing the same general principles.