van Dijk L C, Pieterman H, Han J, van Urk H, Wittens C H
Department of Vascular Surgery, University Hospital Rotterdam Dijkzigt, The Netherlands.
Eur J Vasc Endovasc Surg. 1995 May;9(4):444-7. doi: 10.1016/s1078-5884(05)80013-9.
Intraarterial pressure measurement is the most reliable method to assess haemodynamically significant stenoses in the aortoiliac tract. We have tried to develop a simple and quick, non-invasive method to assess stenoses of this type.
Prospective semi-blinded clinical study.
It was postulated that a haemodynamically significant aortoiliac tract stenosis would result in a lesser degree of vascular resistance decrease after vasodilatation, compared to patients only suffering from femorodistal stenoses. We approximated vascular resistance by: (brachial pressure-ankle pressure)/femoral artery mean Doppler velocity. By dividing vascular resistance at rest by vascular resistance after exercise, we calculated the Resistance Change Ratio (RCR).
In 34 patients (50 legs) with arterial stenoses, the pressure gradient over the aortoiliac segment was compared to the RCR. Legs were divided in three groups: group 1 consisted of 22 legs that showed a pressure gradient > 10 mmHg at rest; group 2 showed a pressure gradient > 10 mmHg after papaverine; group 3 showed a pressure gradient of 10 mmHg or less. The median RCR was: 0.74 (range: 0.23-4.04) for group 1, 0.71 (range: 0.36-1.80) for group 2 and 0.93 (range 0.36-2.06) for group 3. There was no significant difference between the groups (p = 0.19).
The RCR could not be used to accurately detect stenoses in the aortoiliac.
动脉内压力测量是评估主髂动脉段血流动力学显著狭窄的最可靠方法。我们试图开发一种简单快速的非侵入性方法来评估此类狭窄。
前瞻性半盲临床研究。
假定与仅患有股腘动脉狭窄的患者相比，血流动力学显著的主髂动脉段狭窄在血管扩张后血管阻力下降程度较小。我们通过以下公式估算血管阻力：（肱动脉压 - 踝动脉压）/股动脉平均多普勒速度。通过将静息时的血管阻力除以运动后的血管阻力，我们计算出阻力变化率（RCR）。
在34例（50条腿）患有动脉狭窄的患者中，比较了主髂动脉段的压力梯度与RCR。将腿分为三组：第1组由22条腿组成，静息时压力梯度>10 mmHg；第2组在注射罂粟碱后压力梯度>10 mmHg；第3组压力梯度为10 mmHg或更低。第1组的RCR中位数为：0.74（范围：0.23 - 4.04），第2组为0.71（范围：0.36 - 1.80），第3组为0.93（范围0.36 - 2.06）。各组之间无显著差异（p = 0.19）。
RCR不能用于准确检测主髂动脉段的狭窄。
