Response of Ankle Systolic Pressure to Leg Exercise in Mild or Questionable Arterial Disease

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Abstract
Measurement of ankle systolic pressure at rest is a valuable method for evaluation of patients with arterial disease. However, when disease is mild, pressure at rest may be normal. We measured ankle pressure, using a pneumatic cuff and an ultrasonic flow detector, before and after 2.5 minutes of flexion extension of the ankle at the rate of one per second. In 37 normal limbs ankle pressure after exercise either remained above or fell only a few millimeters of mercury below the brachial systolic pressure. In 14 limbs with mild disease, ankle pressure fell more than 16 mm Hg below brachial. Among 18 limbs with questionable disease, three responses were normal, four borderline (ankle pressure, 9 to 16 mm Hg below brachial), and 11 abnormal. Measurement of ankle systolic pressure after exercise is thus useful in the assessment of patients with mild or questionable arterial disease.