Effect of postural change on common femoral artery volume flow, measured by duplex ultrasound, in normal subjects and patients with peripheral vascular disease

Abstract Regulatory peripheral vasoconstriction occurs in response to adoption of the erect posture. Mildly ischaemic limbs are thought to exhibit near normal responses, but patients with rest pain show increases in blood flow on limb dependency. Previous methods of limb blood flow quantification (xenon clearance and venous occlusion plethysmography) have inherent difficulties when applied in these situations. We studied orthostatic responses in 12 normal subjects (aged 22–74 years (median 52)) and 16 patients (aged 21–83 (median 48)) with mild and severe peripheral vascular disease, using a duplex flowmeter system. In the normal subjects changes in the 60s mean, common femoral artery volume flow values were as follows (mlmin −1 (1 SD)): 77 (83), − 78 (116) and − 190 (136), for elevation, dependency, and standing respectively. For claudicants ( n = 7) the values were 18 (37), − 112 (123) and − 216 (103) respectively. In rest pain patients ( n = 9) the responses were reversed, being − 252 (124), 131 (89) and 184 (85) respectively. Significant differences were apparent between elevation, dependency and standing flows in each of the three groups ( P P P