Assessment of the distal lower limb arteries: a comparison of arteriography and Doppler ultrasound.

Simple Doppler was compared with routine arteriography in assessing patency of the arteries at the ankle and the pedal arch. Fifty-six limbs were evaluated--29 with rest pain or trophic lesions, 20 with claudication, and 7 without symptoms. On Doppler examination 177 of 220 (80%) vessels were assessed patent, compared with 127 of 220 (58%) on arteriography. Of the 49 judged occluded on arteriograms, 59% were patent by Doppler and of 44 in which arteriograms were inadequate 82% had Doppler signals. Doppler signals could be heard in 20 of 177 (11%) vessels only with the feet dependant. This prospective, double-blind study provides numerical data to support the observation that a simple Doppler probe can detect patent distal vessels which may not be demonstrated by routine arteriography. This allows selection of patients for further more detailed arteriograms or for operative exploration with a view to distal bypass grafting.