Critical evaluation of venous occlusion plethysmography in the diagnosis of occlusive arterial diseases in the lower limbs.

In this paper, the value of venous occlusion plethysmography in the differentiation between normal and abnormal is discussed. Data are obtained with an ECG triggered plethysmograph allowing an automatic and also a fast recording of the different parameters of the reactive hyperemia. A group of 74 proven "normal" limbs and of 93 proven "abnormal" limbs was studied. No difference in resting blood flow was seen; however, several parameters derived from reactive hyperemia were significantly different; curves obtained after arrest of the circulation during 3 minutes yielded the best results. Discriminant analysis showed that peak blood flow was the best individual performing parameter; using four variables of the reactive hyperemia curve, an overall performance of 84.9% was obtained with specificity of 93% and sensitivity of 76%. The place of plethysmography in the definition of vascular changes is discussed.