Hemodynamic significance of iliac artery stenosis: Pressure measurements during angiography

Peak systolic pressure gradients were obtained before and after vasodilatation in 42 patients (50 limbs) with arteriographic iliac artery stenosis of questionable significance. Patients were divided into three groups according to per cent narrowing of the iliac artery. Pressure gradients across the site of stenosis tended to be significant in patients with >75% stenosis (≥20 mm Hg) but not in patients with <50% stenosis; patients in the middle group (50-75% stenosis) demonstrated a wide variance. Thus the arteriogram is not an accurate indicator of hemodynamically significant lesions, particularly in patients with 50-75% stenosis where pressure measurements are of greatest value. Variations in the aortic and femoral artery systolic peak pressure occurred following vasodilatation, indicating the importance of simultaneous pressure recording.