Patient and operation selectivity. The peripheral vascular laboratory.

Careful use of the data from the vascular laboratory has resulted in better patient and operation selectivity in peripheral arterial disease of the lower extremities. Using the combination of segmental pressure measured with an ultrasonic Doppler and flow as approximated by the measurement of the rate of pulsatile volume change with a calibrated plethysmograph, objective criteria were established for arterial insufficiency. Using a two cuff technique, resistance indices were established to distinguish femoropopliteal from aortoiliac disease. The ratio of angiograms to femoropopliteal and aortoiliac operations has been reduced from an earlier value of almost 3/1 to the present value of approximately 1/1.