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November 1980

Upstream Stenosis: Its Diagnosis by Doppler Signals From the Femoral Artery

Author Affiliations

From the Departments of Surgery (Messrs Baird, Bird, Clifford, and Lusby) and Medical Physics (Drs Skidmore and Woodcock), Bristol Royal Infirmary, Bristol, England.

Arch Surg. 1980;115(11):1316-1322. doi:10.1001/archsurg.1980.01380110054008

• Transcutaneous femoral artery Doppler signals were measured with a 10-MHz pencil probe in 263 lower limbs of 135 patients. The Doppler waveforms were compared with arteriograms in 125 limbs with lower-limb ischemia and in 138 controls in the detection of minor (<50%) and major (>50%) iliac-artery stenosis. Doppler maximum velocity-time waveforms were obtained using a maximum frequency follower, and the waveform shape was analyzed using a Laplace transform (LT) to produce a coefficient, the LT damping. Pulsatility index (PI) was also calculated. In 62 limbs with minor iliac artery disease, mean LT damping was significantly greater than normal (0.5 ± 0.15 vs 0.33 ± 0.06; P <.001). In 63 limbs with major iliac stenosis, mean LT damping was higher still (0.78 ± 0.16; P <.02). The LT damping was not affected by increased distal impedance and there was a good correlation with iliac stenosis in 65 limbs with an occluded superficial femoral artery (r = −0.73). The results with PI were inferior at every grade of severity of iliac disease when assessed by receiver-operator characteristic curves. These results suggest that LT damping is a sensitive method of analyzing femoral Doppler signals in the noninvasive detection of iliac artery stenosis.

(Arch Surg 115:1316-1322, 1980)

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