DOPPLER SPECTRUM ANALYSIS VERSUS DIRECT FEMORAL-ARTERY PRESSURE MEASUREMENT FOR RAPID ASSESSMENT OF AORTOILIAC OBSTRUCTION

Adequate patient selection is required to limit the clinical workload and improve the cost-effectiveness of noninvasive hemodynamic evaluati on of the aortoiliac system. In a prospective blinded fashion the trad itional invasive technique of direct femoral artery pressure measureme nts and the computerized Doppler spectrum analysis of blood flow veloc ities in the common femoral artery were studied. Both tests for rapid assessment of aortoiliac obstruction were compared with duplex ultraso nographic imaging, using a peak systolic velocity ratio of 2.5 to demo nstrate stenoses of 50% or more. In a series of 17 consecutive patient s (34 aortoiliac segments) with suspected aortoiliac obstructive disea se, a good level of agreement (kappa = 0.6) was found for both methods when compared with duplex scanning. Analysis of deviations from the d uplex registrations indicated an overestimation of the pathologic case s using femoral artery pressure measurements and an underestimation us ing Doppler spectrum analysis of blood flow velocities in the common f emoral artery. Both methods were well tolerated, but femoral artery pr essure measurements had a higher technical failure rate. Because of it s noninvasive character and its feasibility the Doppler technique is p referred for the selection of patients for more extensive duplex sonog raphic investigation.