The approach to problems of arterial insufficiency in the lower extremity due to arteriosclerosis has shifted toward direct surgical attack on the involved vessels whenever possible. Case selection has largely been based on the demonstration of the pathologic anatomy by arteriography. Usually only cases showing a segmental occlusion have been felt suitable for arterial reconstructive procedures. Unfortunately, the highest failure rate in such reconstructions is in the commonest type of case, superficial femoral artery obstruction. Many of the cases which have resulted in dramatic angiographic and clinical success have come from the rather rare group of segmental distal aortic or iliac occlusions.
In an attempt to determine whether there were measurable changes in pressure relationships which might be called pathologic physiology accompanying the pathologic anatomy, the following study was carried out.
Intra-arterial pressure recordings were made on five patients at the time of an arterial reconstructive procedure for segmental