Key Points
- To determine whether basal blood flow and reactive hyperemic vasodilatory responses are impaired in both ischemic and nonischemic limbs of patients with unilateral arteriosclerosis obliterans, and to evaluate the hemodynamic impact of revascularization.
- Measured basal calf blood flow and reactive hyperemic response to femoral arterial occlusion plethysmographically in 20 patients with unilateral arteriosclerosis obliterans (20 stenotic limbs and 20 nonstenotic limbs) and 8 healthy controls.
- Re-evaluated limb hemodynamics in 8 patients following percutaneous transluminal angioplasty or surgical revascularization of the stenotic limb.
- Basal calf blood flow and peak hyperemic flow were significantly reduced in both stenotic and nonstenotic limbs compared with healthy control limbs.
- Following revascularization, peak hyperemic flow increased significantly in stenotic legs (from 12.8 ± 1.9 to 17.6 ± 1.6 mL/min/dL tissue, p<0.01) and nonstenotic legs (from 14.3 ± 1.0 to 20.0 ± 1.6 mL/min/dL tissue, p<0.01), though remaining below control levels.
- Basal calf blood flow was unchanged in stenotic legs after revascularization but increased significantly in contralateral nonstenotic legs (from 2.5 ± 0.3 to 3.4 ± 0.4 mL/min/dL tissue, p<0.01).
Structured PICO
Does revascularization improve basal blood flow and reactive hyperemic response in ischemic and nonischemic legs of patients with unilateral arteriosclerosis obliterans?
PPopulation20 patients with unilateral arteriosclerosis obliterans (ASO) (20 stenotic legs and 20 nonstenotic legs) and 8 healthy subjects (8 control legs).
IInterventionPercutaneous transluminal angioplasty or surgical revascularization (performed in 8 stenotic legs).
CComparatorPre-revascularization state, nonstenotic contralateral legs, and healthy control legs.
OOutcomeBasal calf blood flow and reactive hyperemic response to femoral occlusion (peak hyperemic flow) measured plethysmographically.surrogate
Revascularization of stenotic lesions in unilateral arteriosclerosis obliterans improves vascular response in both the treated and the contralateral nonstenotic limb, suggesting a systemic effect of localized ischemia.