Vascular distensibility and vascular surgery.

The elastic property of an arterial wall decreases considerably with aging and/or with a variety of pathological conditions. The resulting decrease in vascular compliance has a profound physiological effect on arterial perfusion. The objectives of this study were to assess a quantitative measure of peripheral vascular distensibility (D), to apply it in some clinical conditions, and to establish a potential means of predicting success in vascular surgery for limb salvage. A technique described earlier by us for the determination of D based on an accurate measurement of volume change (delta V) with pressure change (delta P) was further analyzed and then tested in four groups: the first two were non-surgical, 18 normal subjects, and 23 hypertensive men paired with 22 normotensive men; the last two were surgical, patients undergoing aortofemoral bypass (AFB) operations for limb salvage (salvaged vs unsalvaged); and patients who underwent below-knee amputations (BKA) for severe arterial insufficiency (healed vs unhealed). The results indicate that D can be used as a reliable assessment of the pathophysiological status of the arterial system in the lower extremity; furthermore, D can be used as a predictor of success in at least two types of vascular procedures: AFB with profundoplasty for limb salvage and BKA for severe arterial insufficiency.