Level of arterial obstruction in patients with peripheral arterial occlusive disease (PAOD) determined by laser Doppler fluxmetry

Abstract

To evaluate the laser Doppler fluxmeter as a non-invasive screening method to determine the level of peripheral arterial occlusive disease (PAOD) in the lower limb. Open study of the veno-arterial reflex (VAR) during a shift in body position using a laser Doppler fluxmeter at five probe positions distal to the knee, compared with the occlusion level determined by arteriography and segmental plethysmography. 50 legs comprising 10 normal controls, 20 legs with suprainguinal obstructions (10 claudication and 10 critical ischaemia) and 20 legs with infrainguinal obstructions (10 claudication and 10 critical ischaemia). Controls had normal VAR (mean flux reductions of 38% during dependency) at all probe positions. Legs with infrainguinal disease had normal reflexes proximally but significantly disturbed reflexes distally, whereas suprainguinal disease showed alterations at all sites. Claudicants had diminished flux reduction (mean 12%) whilst those with critical ischaemia increased the flux (mean 32%). This simple, non-invasive technique may be of use in determining the level of obstruction in PAOD.