Segmental Pressures
Purpose: Used to detect the level of arterial occlusion in Peripheral Arterial Disease. The test allows the examiner to note the location of the arterial occlusion.
Procedure: A cuff is placed above the iliofemoral junction on the thigh, and the systolic pressure of the leg is measured using the technique below. The cuff is repositioned just above the knee, and the procedure below is repeated. The cuff is repositioned below the knee and and the procedure below is repeated. A doppler ultrasound at 8 MHz is used to detect the systolic pressure at each site.
1. The anatomical landmark of the dorsalis pedis artery should be lateral to the extensor hallucis longus tendon.
2. Place the Doppler probe on the palpable dorsalis pedis pulse or on the site that produces the best arterial Doppler signal from the dorsalis pedis artery.
3. Inflate the blood-pressure cuff to 20 to 30 mm Hg above the level at which flow ceases, then deflate the cuff slowly and note the systolic pressure (the pressure at which you first hear the flow from the dorsalis pedis artery).
4. Repeat the procedure for the posterior tibial artery. Then repeat the procedure for the contralateral leg to obtain the systolic pressure from both the dorsalis pedis and posterior tibial arteries. Record these values.
Normal Result: Lower limb systolic pressure is maintained at the iliac, femoral, and the popliteal artery.
Abnormal Result: A greater than 20 mmHg drop in lower limb systolic pressure is noted from one site to another indicating stenosis at the area in which the drop occurred.
Reference
Moneta, G. L., Yeager, R. A., Lee, R. W., & Porter, J. M. (1993). Noninvasive localization of arterial occlusive disease: a comparison of segmental Doppler pressures and arterial duplex mapping. Journal of vascular surgery, 17(3), 578-582.
Procedure: A cuff is placed above the iliofemoral junction on the thigh, and the systolic pressure of the leg is measured using the technique below. The cuff is repositioned just above the knee, and the procedure below is repeated. The cuff is repositioned below the knee and and the procedure below is repeated. A doppler ultrasound at 8 MHz is used to detect the systolic pressure at each site.
1. The anatomical landmark of the dorsalis pedis artery should be lateral to the extensor hallucis longus tendon.
2. Place the Doppler probe on the palpable dorsalis pedis pulse or on the site that produces the best arterial Doppler signal from the dorsalis pedis artery.
3. Inflate the blood-pressure cuff to 20 to 30 mm Hg above the level at which flow ceases, then deflate the cuff slowly and note the systolic pressure (the pressure at which you first hear the flow from the dorsalis pedis artery).
4. Repeat the procedure for the posterior tibial artery. Then repeat the procedure for the contralateral leg to obtain the systolic pressure from both the dorsalis pedis and posterior tibial arteries. Record these values.
Normal Result: Lower limb systolic pressure is maintained at the iliac, femoral, and the popliteal artery.
Abnormal Result: A greater than 20 mmHg drop in lower limb systolic pressure is noted from one site to another indicating stenosis at the area in which the drop occurred.
Reference
Moneta, G. L., Yeager, R. A., Lee, R. W., & Porter, J. M. (1993). Noninvasive localization of arterial occlusive disease: a comparison of segmental Doppler pressures and arterial duplex mapping. Journal of vascular surgery, 17(3), 578-582.
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