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Segmental pressures using the three- or four-cuff method can provide an initial indication of the anatomical location of arterial occlusive lesions1Noninvasive Physiologic Vascular Studies: A Guide to Diagnosing Peripheral Arterial Disease. Robert C. Sibley III, MD Stephen P. Reis, MD Jarrod J. MacFarlane, DO Mark A. Reddick, MD, MS Sanjeeva P. Kalva, MD Patrick D. Sutphin, MD, PhD. RadioGraphics 2017; 37:346–357. . This test is most useful in patients without risk for calcified vessels and with suspected femoral artery occlusions. Segmental pressures could be combined with or replaced by segmental pulse volume recordings (PVR), as this test is not affected by arterial calcification and is easier to tolerate for the patient2Lower extremity arterial evaluation: Are segmental arterial blood pressures worthwhile? Steven S. Gale MD, Robert P. Scissons, RVT, Sergio X. Salles-Cunha, PhD, Steven M. Dosick, MD, Ralph C. Whalen, MD, John P. Pigott, MD, and Hugh G. Beebe, MD, Toledo, Ohio. JOURNAL OF VASCULAR SURGERY May 1998. Volume 27, Number 5. .

  • Can give an indication of the anatomical location of an occlusive lesion.
  • Formerly the most common test to check if a non-diabetic claudicant smoker had an occlusion of the superficial femoral artery.
  • Usually done with cuffs on the ankles and calves, and either one or two cuffs on the upper thigh.
  • Preferably combined with PVR, which is less affected by calcification and is easier for patients to tolerate.

References:

  1. Noninvasive Physiologic Vascular Studies: A Guide to Diagnosing Peripheral Arterial Disease. Robert C. Sibley III, MD Stephen P. Reis, MD Jarrod J. MacFarlane, DO Mark A. Reddick, MD, MS Sanjeeva P. Kalva, MD Patrick D. Sutphin, MD, PhD. RadioGraphics 2017; 37:346–357.
  2. Lower extremity arterial evaluation: Are segmental arterial blood pressures worthwhile? Steven S. Gale MD, Robert P. Scissons, RVT, Sergio X. Salles-Cunha, PhD, Steven M. Dosick, MD, Ralph C. Whalen, MD, John P. Pigott, MD, and Hugh G. Beebe, MD, Toledo, Ohio. JOURNAL OF VASCULAR SURGERY May 1998. Volume 27, Number 5.
 PeriFlux 6000
Combined System

Instructional Video
ESVS Educational Video –
Prof. Pirkka Vikatmaa
Helsiniki University Hospital

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