Digital Systolic Pressures in the Lower Limb in Arterial Disease

Abstract

Systolic pressures were measured by using pneumatic cuffs on the second toe, ankle, and arm. In the absence of clinically evident peripheral vascular disease, digital pressure expressed as a percentage of the brachial pressure averaged 87% and was not significantly different in older normal persons, patients with hypertension, diabetes mellitus, or coronary artery disease from that in young normal subjects. Digital pressures were decreased in patients with arteriosclerosis and thromboangiitis obliterans, or Raynaud's phenomena. Mean digital pressures correlated well with clinical and angiographic findings. In arteriosclerosis obliterans digital pressures in the limbs with claudication averaged 43% of the brachial pressure, and in patients with rest pain or skin lesions, or both, 21%. The ankle-to-toe pressure difference was increased in the majority of patients with thromboangiitis obliterans and in some diabetics with arteriosclerosis obliterans. The results indicate that digital pressure expressed as percentage of brachial pressure is a good index of the severity of the overall occlusive process, whereas the ankle-to-toe pressure difference may provide a useful index of the disease in the small distal arteries.