Abstract
Accurate, noninvasive, hemodynamic assessment of atherosclerosis involving the aortoiliac segment remains a frontier in vascular surgery. Femoral pulsatility index, a vessel/probe angle independent function derived from the common femoral artery sonogram, was evaluated by comparison to the invasive hemodynamic parameters of pressure and flow in the presence of experimentally produced, quantitated, iliac and superficial femoral arterial stenoses. The external iliac, common femoral, and superficial femoral arteries in 10 adult mongrel dogs were used. An arterial constrictor was placed around the external iliac and ipsilateral superficial femoral arteries so that the vessels could be constricted either individually or simultaneously. Superficial femoral artery branch vessels were cannulated for monitoring of intraarterial pressure. Simultaneously, flow was measured from the common femoral artery by a square-wave electromagnetic flow meter together with directional Doppler ultrasound magnetic tape recordings. Sound signals were then processed through a frequency spectrograph for calculation of pulsatility index. With increasing degree of stenosis, decreases in pulsatility index paralleled decreases in both pressure and flow. Large individual variance in femoral pulsatility index existed among animals for any given degree of stenosis. Changes in pulsatility index recorded from the common femoral artery were not significantly different when either an iliac artery stenosis or superficial femoral artery stenosis was present. In this nonatherosclerotic canine model using accurately placed and quantitated arterial stenoses, femoral pulsatility index was unable to reliably quantitate arterial stenoses and could not differentiate between inflow and outflow lesions.
Published Version
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