Hemodynamics in arterial reconstructions of the lower limb. II. Blood pressure.

In order to demonstrate common pressure gradients and peripheral arterial pressure in ileo-femoro-popliteal arteries before and after reconstruction for atherosclerosis, intra-operative pressure measurements were performed on 204 patients. Before reconstruction, the pressure differential was 44.3 mmHg in femoro-popliteal arteries and 29.0 mmHg in the iliac arteries. This was reduced to 8.4 and 4.1 mmHg by the reconstructions. In patients with femoro-popliteal disease, the pressure gradient was higher when gangrena or rest pain were present than when claudication was the principal symptom. When the iliac arteries were mainly involved, no such difference was seen. Postoperative gradients were slightly higher in arteries subjected to primary failure than in vessels remaining patent. The blood flow increase from intra-arterial papaverine injections accentuated existing pressure gradients and frequently disclosed gradients not manifest at basal flow rates.