Intraoperative assessment of the hemodynamic significance of iliac and profunda femoris artery stenosis
Archie, J.P.; Feldtman, R.W.
Surgery 90(5): 876-880
1981
ISSN/ISBN: 0039-6060 PMID: 7302840 Document Number: 173833
The hemodynamic significance of stenosis was defined by intraoperative measurement of pressure and flow across 22 profunda femoris and 44 iliac artery segments. Measurements were taken at rest and during papaverin-induced vasodilation, and the mean pressure gradient across the arterial segment at double resting flow was calculated. Profunda femoris artery mean pressure gradients at resting flow .ltoreq. 3 mm Hg for stenoses up to and including 75%. The mean pressure gradient at double resting flow increased significantly in profunda femoris arteries with > 60% stenosis and was > 10 mm Hg in 7 of 10 profunda femoris arteries with 60%-70% stenosis. Resting mean iliac artery pressure gradients were < 10 mm Hg in 38 of 39 arteries with < 90% stenosis and < 5 mm Hg in 35 of 39. The mean iliac artery pressure gradient at double resting blood flow exceeded 10 mm Hg in 11 of 12 arteries with > 70% stenosis and was > 8 mm Hg in all 12. Four of 19 iliac arteries in the range of 20-65% stenosis as measured by arteriography had pressure gradients at double resting flow > 10 mm Hg. The hemodynamic significance of profunda femoris artery stenosis can be determined by intraoperative measurement of mean pressure gradients at double resting blood flow. Mean iliac artery pressure gradients at double resting blood flow may be useful for estimating the hemodynamic significance of iliac stenosis in situations where angiographic findings show mild-to-moderate iliac stenosis.