Non-invasive Vascular Laboratory Evaluation of the Upper Extremity.

A wide range of vascular pathologies can lead to upper extremity ischemia, including atherosclerotic disease, complications following arterial bypass graft, steal from hemodialysis fistula or graft, trauma including iatrogenic injury, vascular compression syndromes, collagen vascular disorders and vasospasm. Non-invasive vascular laboratory testing can be helpful in diagnosis as well as follow-up to assess disease progression and response to therapy. In this article, the technique and interpretation of physiological testing studies such as the wrist brachial index, digital brachial indices, segmental pressure measurements and pulse volume recordings are reviewed. Demonstrative clinical cases are provided with Doppler ultrasound, CT angiography, and angiography correlation.