Peripheral Vascular Diseases

Abstract

The major symptoms in patients with peripheral arterial occlusive disease (PAOD) are claudication, rest pain, and skin necrosis or gangrene. In these patients the arterial circulation of the limb can be evaluated by a number of different methods, e. g., plethysmography, arterial pressure measurements, and Doppler ultrasound techniques. All these methods are very useful in clinical practice for evaluating the degree and location of an arterial obliteration. However, the local microcirculation of the tissue at risk of ischemia cannot be evaluated by these macrocirculatory methods [1]. For this purpose other techniques, e. g., skin temperature measurements, Xenon clearance, and transcutaneous pO₂ measurements, have been used. Although these methods have also been found to be clinically valuable, most of them are very tedious to use, and they react very slowly to changes in blood flow. Because of their limited frequency response, the normal, rather fast spontaneous fluctuations in tissue blood flow cannot be recorded. Moreover, these methods give only indirect indications of what is happening in the microcirculation of the tissue studied and cannot be used for evaluating the dynamics of the blood flow in the region. New techniques have been introduced during the past decade for studying the skin’s microcirculation in clinical practice [1]. One such method is laser-Doppler flowmetry (LDF).