Difficulty in assessing the severity of aorto-iliac disease by clinical and arteriographic methods.

Accurate hemodynamic assessment of the severity of aorto-iliac disease has important implications in the management of patients with symptomatic peripheral arterial occlusive disease. This study has documented that history, clinical examination, and single-plane angiography are often unsatisfactory for assessing the hemodynamic significance of an aorto-iliac lesion. The use of oblique angiographic views, certain noninvasive methods, such as quantitative Doppler waveform analysis, and direct pressure measurements will be of benefit in difficult cases and lead to a more accurate diagnosis.