Hemodynamic assessment of the aortoiliac segment: a prospective study.

A test for assessing stenosis in the aortoiliac segment is described in which femoral pressure is measured directly by continuous monitoring and an intra-arterial injection of papaverine is used to augment blood flow. This test has been described previously but is not widely used. A prospective study of this test was carried out on 64 patients and the results were compared with those obtained by aortography. The test helped to determine whether an operation on the aortoiliac segment was indicated. Clinical results were assessed. Thirty-two of the 64 patients were found to have significant inflow disease (more than 50% stenosis). They underwent aortic reconstruction with total relief or improvement of symptoms in all cases. Aortography demonstrated an essentially normal aortoiliac segment in 3 of the 32 patients and 16 had only irregular segments with no definite stenosis. The authors conclude that any patient presenting with sufficient indication to warrant reconstructive surgery who has a normal or equivocal angiogram should undergo the papaverine pressure test.