Quantitative assessment of peripheral occlusive arterial diseases by color duplex sonography and blood endothelin level.

Abstract

To evaluate peripheral occlusive diseases quantitatively, we performed color duplex sonography and measured the blood endothelin (ET-1) level. We measured the systolic velocities of the dorsal pedial and the posterior tibial arteries as well as the brachial artery. We also calculated the flow volume, and the ratio of systolic velocities and flow volume of the lower to upper extremity (AVI, AFI). Furthermore we measured the blood ET-1 level and investigated the relationship between this value and clinical symptoms. The value of AVI as well as AFI decreased in the order of Fontaine class I, II, III and IV. In four limbs with a Fontaine class greater than II with a normal ankle pressure index, the values of AVI were low. On the other hand, three limbs with normal values of peak-AVI (> 0.9) and lower API (< 0.75) were in Fontaine class I. The value of the ET-1 level was higher in Fontaine class III and IV than in class II, and decreased after revascularization along with improvement of clinical symptoms. The new AVI and AFI values showed a better correlation with clinical symptoms than API. The ET-1 level was significantly higher in Fontaine class III and IV, and showed marked regression after arterial reconstruction. Thus, the new AVI and AFI values may provide a novel means of identifying patients with the peripheral occlusive diseases, and the measurement of ET-1 level may be potentially useful in identifying the severity of arteriosclerosis.