Clinical use of an ultrasonic Doppler flow meter in arterial occlusive diseases of the lower extremities.

Abstract

Diagnostic value of a transcutaneous Doppler flow meter in arterial occlusive diseases was studied. Ankle systolic pressures at rest and after exercise were measured by placing a flow probe over the dorsalis pedis artery and posterior tibial artery. A pressure index was obtained by comparing the ankle and brachial pressure. Exercise tolerance was determined by dorsoplantar flexion of ankle, 20 times per minute for 2 minutes, and two parameters, % fall of ankle pressure and recovery time, were calculated. A pressure index was well correlated with the site of arterial occlusion and the degree of clinical symptoms. However, it was difficult to evaluate the circulatory insufficiency of the limbs between diseased and normal persons in the cases of below knee obstruction and clinically mild ones. Measurement of ankle pressure after exercise gave us better information of circulatory insufficiency in the lower extremi­ ties, especially in mild cases. The % fall of ankle pressure and recovery time were well correlated with the degree of clinical symptoms and few cases overlapped with normal subjects. Statistical exploration also revealed that the higher value between the ankle pressure measured over the dorsalis pedis artery and that over the posterior tibial artery, signiflcantly refracted circulatory insufficiency in the lower extremities. Moreover, it was found that measurement of ankle pressure was useful in the assess­ ment of reconstructive arterial surgery.