Utility of wide and narrow blood pressure cuffs in the hemodynamic assessment of aortoiliac occlusive disease.

One hundred lower extremities were evaluated by measurement of common femoral intra-arterial pressure and high-thigh Doppler-derived segmental pressures using wide and narrow blood pressure cuffs to assess the accuracy of high-thigh pressures in the evaluation of aortoiliac disease. Sixty-four extremities were also studied by arteriography. The results were analyzed using the common femoral intra-arterial pressure as the standard. The accuracy was poor for both the wide (52%) and narrow (73%) cuff techniques. No significant differences between the two techniques were evident in regard to the incidence of false positive (wide cuff, 75%; narrow cuff, 65%) and false negative (wide cuff, 3%; narrow cuff, 8%) tests. Superficial femoral artery disease was found to be responsible for all false positive tests using the narrow cuff technique (20 of 20) and all but one of the false positive tests using the wide cuff technique (34 of 35). These data indicate that segmental high-thigh pressures are useful primarily as a screening technique (low false negative rate) to exclude hemodynamically significant aortoiliac occlusive disease at rest.