Doppler waveform analysis versus segmental pressure and pulse-volume recording: assessment of occlusive disease in the lower extremity.

In a prospective study, the accuracy of combined segmental pressure measurements and pulse-volume recordings was compared with Doppler waveform analysis in evaluating peripheral arterial occlusive disease. Before arteriography, 50 patients (100 limbs) underwent vascular assessment which included measurement of the segmental pressure and pulse volume at the thigh, calf and ankle. Analogue Doppler waveform tracings were obtained from the femoral, popliteal and tibial arteries and used to calculate the pulsatility index and inverse damping factor. Results of each method were assessed by independent observers and compared with the arteriographic data. No appreciable difference was demonstrated between the two methods, both giving an overall accuracy in the 90% to 95% range. Both accurately predicted the severity of iliac and superficial femoral artery obstruction and distinguished iliac from proximal disease of the superficial femoral artery. Outflow disease (tibial arteries) was better assessed by measurement of segmental pressures than by Doppler waveform analysis or pulse-volume recording alone.