A Novel Simple Technique Using Hyperemia to Enhance Pressure Gradient Measurement of the Lower Extremity during Peripheral Intervention

Issam Koleilat, Bruce Gray

Research output: Contribution to journalArticle

Abstract

Purpose: To describe a novel technique coupling the use of a pressure-wire gradient measurement with and without hyperemia (induced with an external blood pressure cuff inflated to 20 mmHg above the systolic blood pressure for 1 minute on the affected calf). Case: A 70-year-old patient presented with lifestyle-limiting lower-extremity calf claudication. He underwent angiography, which revealed left superficial femoral artery stenosis. Angioplasty of the lesion improved the angiographic appearance, but a residual pressure gradient could be elicited with provocative hyperemia testing. This prompted stenting, which resolved the differential. Conclusions: Pressure-wire gradient detection with and without provocative hyperemia testing using our novel approach may prove to be a useful adjunct in the diagnosis and treatment of lower extremity occlusive disease.

Original languageEnglish (US)
Pages (from-to)166-172
Number of pages7
JournalVascular Disease Management
Volume12
Issue number9
StatePublished - Sep 1 2015
Externally publishedYes

Fingerprint

Hyperemia
Lower Extremity
Blood Pressure
Pressure
Femoral Artery
Angioplasty
Life Style
Angiography
Pathologic Constriction
Therapeutics

Keywords

  • fractional flow reserve
  • hyperemia
  • peripheral vascular intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "Purpose: To describe a novel technique coupling the use of a pressure-wire gradient measurement with and without hyperemia (induced with an external blood pressure cuff inflated to 20 mmHg above the systolic blood pressure for 1 minute on the affected calf). Case: A 70-year-old patient presented with lifestyle-limiting lower-extremity calf claudication. He underwent angiography, which revealed left superficial femoral artery stenosis. Angioplasty of the lesion improved the angiographic appearance, but a residual pressure gradient could be elicited with provocative hyperemia testing. This prompted stenting, which resolved the differential. Conclusions: Pressure-wire gradient detection with and without provocative hyperemia testing using our novel approach may prove to be a useful adjunct in the diagnosis and treatment of lower extremity occlusive disease.",
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AB - Purpose: To describe a novel technique coupling the use of a pressure-wire gradient measurement with and without hyperemia (induced with an external blood pressure cuff inflated to 20 mmHg above the systolic blood pressure for 1 minute on the affected calf). Case: A 70-year-old patient presented with lifestyle-limiting lower-extremity calf claudication. He underwent angiography, which revealed left superficial femoral artery stenosis. Angioplasty of the lesion improved the angiographic appearance, but a residual pressure gradient could be elicited with provocative hyperemia testing. This prompted stenting, which resolved the differential. Conclusions: Pressure-wire gradient detection with and without provocative hyperemia testing using our novel approach may prove to be a useful adjunct in the diagnosis and treatment of lower extremity occlusive disease.

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