The association between laser Doppler reactive hyperaemia curves and the distribution of peripheral arterial disease

Abstract

Objective: to determine whether postocclusive laser Doppler fluxmetry (LDF) curves can be related to the arteriographic distribution of disease. Design: prospective study. Materials: sixty-nine patients with symptomatic peripheral ischaemia and 15 healthy subjects. Methods: laser Doppler fluxmetry (LDF) was monitored on the dorsum of the symptomatic foot following 2 min of arterial occlusion at the ankle. During reperfusion three patterns of LDF were identified (types I-III). All patients subsequently underwent arteriography which was reported independent of LDF results. The distribution of disease, particularly patency of below-knee vessels, was related to the type of LDF curve observed during reactive hyperaemia. Results: type I curves were observed in all healthy subjects and 75% of patients with a single arterial lesion. Type II curves were found in 78% of patients with multiple lesions above the knee. The presence of either a type I or II curve was associated with a continuous vessel from knee to ankle (positive predictive value 83%, p < 0.01), whilst type III curve was associated with discontinuous infrapopliteal run-off (positive predictive value 86%, p < 0.01%). Conclusions: this pilot study suggests that post-occlusive LDF curves may identify the distribution of arterial disease and may be useful in the non-invasive management of peripheral ischaemia.