II. Technique

  1. Measure highest systolic reading in both arms
    1. Record first doppler sound as cuff is deflated
    2. Record at the radial pulse
    3. Use highest of the two arm pressures
  2. Measure highest systolic reading at 4 points per leg
    1. Cuff Locations
      1. High Thigh
      2. Low Thigh
      3. Calf (below knee)
      4. Above ankle
    2. Record first doppler sound as cuff is deflated
    3. Record at dorsalis pedis or posterior tibial pulses
  3. Calculate ratio of leg to brachial Blood Pressure
    1. Divide each leg cuff by highest brachial pressure
    2. Use similar method as in Ankle-Brachial Index
  4. Consider repeating above readings after Exercise
    1. Patient walks until absolute Claudication distance

III. Interpretation: Findings suggestive of Occlusion

  1. Proximal lower extremity pressures less than arms
  2. Proximal femoral pressure <20 mmHg over brachial
  3. Drop in doppler pressures between segments >20-30 mmHg

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