Noninvasive Diagnostic Assessment of Peripheral Vascular Disease

Barnes, Robert W. MD

From the Department of Surgery, University of Arkansas for Medical Sciences and the Surgical Service, John L. McClellan Veterans Administration Medical Center, Little Rock, Ark.

Address for correspondence and reprints: Robert W. Barnes, MD, UAMS, Slot 520, 4301 West Markham, Little Rock, AR 72205.

Presented in part at the American Heart Association Scientific Conference on Peripheral and Noncoronary Vascular Disease, Dallas, Texas, January 21-23, 1990.

Circulation 83(2):p I20-I27, February 1991.

Noninvasive techniques have assumed an increasingly important role in the management of patients with vascular disease. Both ultrasonic and plethysmographic instruments allow objective evaluation of vascular disorders by the measurement of segmental limb blood pressures, analysis of blood velocity disturbances, recording of digit or limb pulse waveforms, or imaging of vascular disease, with or without Doppler flow analysis or color-flow mapping. These techniques have been applied for screening asymptomatic individuals, diagnosis of symptomatic patients, monitoring of interventional or surgical procedures, and follow-up of the natural history or the efficacy of medical, interventional, or surgical therapy of vascular disease. This article reviews the clinical application of these modalities to patients with peripheral arterial disease and briefly discusses cost-effectiveness and potential abuses of noninvasive technology. (Circulation 1991;83I[suppl 11:I-20–I-27)