EARLY DIAGNOSIS OF LOWER-LIMB PERIPHERAL VASCULAR-DISEASE WITH MEASURES SUITED TO GENERAL-PRACTITIONERS - SYSTOLIC INDEX AND PULSES PERCEPTION

Atherosclerotic lower-limb arteriopathy is a serious disease. Its prev alence often undrestimated when relying only on questioning the patien t. A simple early detection method is the systolic index, i.e. the rat io of systolic ankle over brachial pressure. This ratio should normall y be greater than 0.9. Lower values indicate detectable arterial obstr uction as revealed by reduced peripheral perfusion. Under 0.75 patient s are considered as suffering from peripheral vascular disease and req uire further investigations and specialist opinion. With an index betw een 0.75 and 0.90 patients are classified as stage I or II of the dise ase. In a survey by 180 General Practitioners, which were trained by a ngiologists to measure ankle pressure, more than 1 400 patients, betwe en 40 and 75-years old, with at least one vascular risk factor (hypert ension, diabetes, lipids, tobacco) were selected. Tobacco was the most prevalent vascular risk factor, then diabetes (particularly in men). 23.8 % of patients recorded values between 0.90 and 0.75 and thus suff ering from peripheral vascular disease (certainly age dependent). Clin ically absent pulses at the posterior tibial and the dorsalis pedis ar tery were found is 19 and 27 % of patients respectively. Most of the p atients received a pharmacological substance allowing to check this in dex sensitivity. Thus systolic index is a simple low cost method for e arly detection and care and more general utilisation is poposed.