Noninvasive Diagnosis of Vascular Disease by Falls B. Hershey, Robert W. Barnes and David S. Sumner

By Falls B. Hershey, Robert W. Barnes and David S. Sumner (Eds.)

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New York, Grune & Stratton, 1975. SKIN 25° 1 ^ ~ TEMPERATURE 30° ~ y ^ 35° J\, Figure 3-2. Effect of different finger temperatures on digit pulse volume. Reprinted with permission from Strandness DE Jr, Sumner DS: Hemodynamics for Surgeons. New York, Grune & Stratton, 1975. pulse is very sensitive to changes in temperature (Figure 3-2), and when the part being examined is cold, the pulse volume diminishes and may assume an "obstructive" contour or disappear entirely. Because of this behavior, all plethysmographic studies should be performed in a warm room (about 25 °C).

19. Raines JK, Darling RC, Buth J, et al: Vascular laboratory criteria for the management of peripheral vascular disease of the lower extremities. Surgery 79: 212, 1976. 20. Sumner DS: Rational use of noninvasive tests in designing a therapeutic approach to severe arterial disease of the legs. In Hemodynamics oftheLimbs—2. Edited by P Puel, H Boccalon, A Enjalbert. Toulouse, France, GEPESC, 1981, pp 369-367. 21. Sumner DS: Algorithms using non-invasive data as a guide to therapy of arterial insufficiency.

Raynaud's phenomenon, on the other hand, may occur in extremities with anatomic- 27 Noninvasive Diagnosis of Arterial Occlusive Disease ally intact vessels or in extremities with fixed arterial obstruction, usually in the digital, palmar, or forearm arteries. When the ischemia is due only to digital arterial spasm, the condition is called Raynaud's disease, but when the intermittent ischemia is due to the normal vasoconstrictive responses of the arterioles or digital arteries superimposed on a fixed arterial obstruction, the condition is called secondary Raynaud's phenomenon.

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