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

AIM 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. DESIGN 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. MATERIALS 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). RESULTS 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%). CONCLUSION This simple, non-invasive technique may be of use in determining the level of obstruction in PAOD.

[1]  E. Bernstein,et al.  Thigh pressure artifacts with noninvasive techniques in an experimental model. , 1981, Surgery.

[2]  V. C. Roberts,et al.  Limb perfusion in the lower limb amputee—a comparative study using a laser Doppler flowmeter and a transcutaneous oxygen electrode , 1987, Prosthetics and orthotics international.

[3]  R. Rutherford,et al.  Combining segmental systolic pressures and plethysmography to diagnose arterial occlusive disease of the legs. , 1979, American journal of surgery.

[4]  F L Golbranson,et al.  Transcutaneous PO2 measurements in health and peripheral arterial occlusive disease. , 1982, Surgery.

[5]  C. B. Ernst,et al.  Limitations of the femoral artery pulsatility index with aortoiliac artery stenosis: an experimental study. , 1986, Journal of vascular surgery.

[6]  A. Nicolaides,et al.  Combined evaluation of postphlebitic limbs by laser doppler flowmetry and transcutaneous PO2/PCO2 measurements. , 1988, VASA. Zeitschrift fur Gefasskrankheiten.

[7]  G. L’italien,et al.  Anatomic localization of atherosclerotic lesions by hemodynamic tests. , 1981, Archives of surgery.

[8]  O. Henriksen,et al.  Local regulation of subcutaneous forefoot blood flow during orthostatic changes in normal subjects, in sympathetically denervated patients and in patients with occlusive arterial disease. , 1985, Cardiovascular research.

[9]  L. Hillestad The peripheral blood flow in intermittent claudication. III. The significance of oscillometry. , 2009, Acta medica Scandinavica.

[10]  O Henriksen,et al.  Local reflex in microcirculation in human subcutaneous tissue. , 1976, Acta physiologica Scandinavica.

[11]  A. Creutzig,et al.  Disturbances of skin microcirculation in patients with chronic arterial occlusive disease and venous incompetence. , 1988, VASA. Zeitschrift fur Gefasskrankheiten.

[12]  B. Fagrell,et al.  Discrepancies between total and nutritional skin microcirculation in patients with peripheral arterial occlusive disease (PAOD). , 1990, VASA. Zeitschrift fur Gefasskrankheiten.

[13]  J. Tooke,et al.  Mechanism of the postural vasoconstrictor response in the human foot. , 1988, Clinical science.

[14]  Kempczinski Rf Segmental volume plethysmography in the diagnosis of lower extremity arterial occlusive disease. , 1982 .

[15]  G. Bone,et al.  Value of arterial pressure measurements in the proximal and distal part of the thigh in arterial occlusive disease. , 1978, Surgery, gynecology & obstetrics.

[16]  G Rayman,et al.  Blood flow in the skin of the foot related to posture in diabetes mellitus , 1986, British medical journal.

[17]  J. A. Schwartz,et al.  Hemodynamic and arteriographic evaluation of femoral pulsatility index. , 1982, The Journal of surgical research.

[18]  K. Kvernebo,et al.  Laser Doppler flowmetry in evaluation of lower limb resting skin circulation. A study in healthy controls and atherosclerotic patients. , 1988, Scandinavian journal of clinical and laboratory investigation.