PROSPECTIVE-STUDY OF DOPPLER PRESSURES AND SEGMENTAL PLETHYSMOGRAPHY BEFORE AND FOLLOWING AORTOFEMORAL BYPASS - IMPLICATIONS FOR PREDICTING SUCCESS AND FOR ADOPTING A UNIFORM METHOD OF CLASSIFYING ARTERIAL-DISEASE

  • 1 January 1979
    • journal article
    • research article
    • Vol. 86  (1) , 120-129
Abstract
To determine the clinical and hemodynamic changes associated with aortofemoral bypass, 44 limbs of 31 patients underwent segmental plethysmography (PVR) and Doppler pressures (DSP) before operation, immediately after operation and again at 6 mo. Prior to operation patients were separated by angiographic criteria into 2 groups: aortoiliac segment disease alone (AI) (n = 22), and aortoiliac and femoropopliteal segment disease (AIFP) (n = 22). At 6 mo. the 2 groups were subdivided into 4 groups based on relief (.hivin.oSx) or lack of relief (+Sx) of symptoms. Before operation the only significant difference between the 4 groups was a higher thigh PVR and calf DSP in the AI + Sx group. Six month PVR values in AI.hivin.oSx were improved nearly 2-fold over preoperative measurements at the thigh and calf, but at the thigh level only for AIFP.hivin.oSx. DSP was increased at all 3 levels in both AI and AIFP.hivin.oSx groups. No hemodynamic improvement occurred in either the AI or the AIFP+Sx groups. A derivative index of PVR (thigh-ankle/15 mm) or the FP.OMEGA. was significantly lower in AIFP.hivin.oSx before operation. There was a significant disparity between classification by hemodynamics and by symptoms prior to operation which lessened somewhat after operation. Success or failure apparently can be predicted before operation in AIFP by FP.OMEGA.. Arterial disease should be classified by a combination of symptoms, angiography and hemodynamics.