The noninvasive vascular laboratory aids in the evaluation of patients with peripheral arterial disease (PAD). Several qualitative and quantitative noninvasive tests are useful for diagnosing PAD and monitoring patients' response to treatment. These tests include Doppler ultrasonography, pulse volume recording, segmental blood pressure measurement, exercise testing, post-occlusive reactive hyperemia testing, transcutaneous oximetry and color-assisted ultrasound imaging. Each test has specific utility and can be used either individually or in combination with other noninvasive tests to obtain information about the hemodynamic and functional severity of peripheral atherosclerosis in patients with claudication.
NicholsWWO'RourkeMF eds. McDonald's blood flow in arteries: theoretic, experimental and clinical principles.Philadelphia: Lea and Febiger, 1990: 251–69.
8.
YoungDFCholvinNRRothAC. Pressure drop across artificially induced stenoses in the femoral artery of dogs. Circ Res1975; 36: 735–43.
9.
SchultzRDHokansonDEStrandnessDEJr.Pressure–flow and stress strain measurements of normal and diseased aortoiliac segments. Surg Gynecol Obstet1967; 124: 1267–76.
10.
CutajarCLMarstonANewcombeJF. Value of cuff occlusion pressures in assessment of peripheral vascular disease. Br Med J1973; ii: 392–95.
11.
YaoSTHobbsJTIrvineWT. Ankle systolic pressure measurements in arterial disease affecting the lower extremities. Br J Surg1969; 56: 676–79.
12.
HiattWRNawazDRegensteinerJGHossackKF. The evaluation of exercise performance in patients with peripheral vascular disease. J Cardioplmon Rehabil1988; 12: 525–32.
13.
GardnerAWSkinnerJSCantwellBWSmithLK. Progressive vs. single-stage treadmill tests for evaluation of claudication. Med Sci Sports Exerc1991; 23: 402–408.
14.
JorfeldtLWahrenJ.Leg blood flow during exercise in man. Clin Sci1971; 41; 459–73.
15.
JohnsonWC. Doppler ankle pressure and reactive hyperemia in the diagnosis of arterial insufficiency. J Surg Res1975; 18; 177–80.
16.
KeagyBAPharrWFThomasDBowesDE. Comparison of reactive hyperemia and treadmill tests in the evaluation of peripheral vascular disease. Am J Surg1981; 142: 158–61.
17.
ByrnePProvanJLAmeliFMJonesDP. The use of transcutaneous oxygen tension measurements in the diagnosis of peripheral vascular insufficiency. Ann Surg1984; 200: 159–65.
18.
RookeTWOsmundsonPJ. The influence of age, sex, smoking and diabetes on lower limb transcutaneous oxygen tension in patients with arterial occlusive disease. Arch Intern Med1990; 150: 129–32.
MerrittCRB.Doppler color flow imaging. J Clin Ultrasound1987; 15: 591–97.
21.
ZeuchnerJGeitungJTLukesPGothlinJH. Angiography and colour flow duplex ultrasonography in the evaluation of peripheral ischemic-occlusive arterial disease. Acta Radiol1994; 35: 270–74.
CossmanDEllisonJWagnerWHComparison of contrast arteriography to arterial mapping with color-flow duplex imaging in the lower extremities. J Vasc Surg1989; 10: 522–29.
KohlerTRNanceDRCramerMMVandenburgheNStrandnessDEJr.Duplex scanning for diagnosis of aortoiliac and femoropopliteal disease: a prospective study. Circulation1987; 76: 1074–80.
26.
MonetaGLYeagerRALeeRWPorterJM. Noninvasive localization of arterial occlusive disease: a comparison of segmental Doppler pressures and arterial duplex mapping. J Vasc Surg1993; 17: 578–82.
27.
MillsJLHarrisEJTaylorLMJrBeckettWCPorterJM. The importance of routine surveillance of distal bypass grafts with duplex scanning: a study of 379 reversed vein grafts. J Vasc Surg1990; 12: 379–89.
28.
LabordeALSynnAYWorseyMJA prospective comparison of ankle/brachial indices and color duplex imaging in surveillance of the in situ saphenous vein bypass. J Cardiovasc Surg1992; 33: 420–25.
29.
BandykDFCatoRFTowneJB. A low flow velocity predicts failure of femoropopliteal and femorotibial bypass grafts. Surgery1985; 98: 799–809.
