Noninvasive Vascular Diagnosis

pp 287-302


Segmental Doppler Pressures and Doppler Waveform Analysis in Peripheral Vascular Disease of the Lower Extremities

  • Stephen M. HassAffiliated withDepartment of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center
  • , Ali F. AbuRahmaAffiliated withDepartment of Surgery, Robert C. Byrd Health Sciences Center, West Virginia UniversityCharleston Area Medical Center Email author 

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Segmental Doppler pressures and Doppler waveform analysis are important tools in the diagnosis of patients with peripheral vascular disease of the lower extremities. A complete arterial lower extremity Doppler examination consists of three components: (1) analysis of the arterial analog wave tracing, (2) measurement of the segmental systolic limb pressures, and (3) calculation of the ankle-brachial index (ABI).

Doppler segmental pressures have the same capabilities of analog wave tracing, i.e., to help in identifying the presence and severity of arterial occlusive disease, to provide an objective baseline to follow the progression of peripheral vascular disease of the lower extremity and/or the postoperative course, and to somewhat evaluate the treatment plan.

Four 12 × 40 pneumatic cuffs are applied at various levels on each leg: as high on the thigh as possible, just above the knee, just below the knee, and above the ankle. The examiner then listens to the posterior tibial and the dorsalis pedis arterial signals. Of these vessels, the one with the strongest Doppler signal is chosen for the ankle pressure. High-thigh, above-knee, below-knee, and ankle pressure readings are taken.

Another component of the arterial lower extremity Doppler examination is the calculation of the ABI. It is generally agreed upon that an ABI of 0.9–1.0 signifies normalcy or minimal arterial occlusive disease, an ABI of 0.5–0.9 signifies a claudication level, less than 0.5 signifies the presence of ischemic rest pain or severe arterial occlusive disease, and less than 0.3 is compatible with trophic changes of the lower extremities.


Noninvasive vascular testing Doppler Peripheral vascular disease Lower extremities