The arteriograph is a clinically and scientifically patented measurement system that can be used to assess various measurement parameters of the arterial vascular system. The primary application of the arteriograph is in the visualization of arterial stiffness. Arterial stiffness itself describes both the structural and functional properties of the arterial vasculature. For precise evaluation of the arterial vasculature, several parameters are required, each of which can be assessed with high sensitivity using the arteriograph (sensitivity: percentage of diseased patients in whom disease is detected by use of the test, ie, a positive test result occurs).
Indications (areas of application)
- Determination of pulse wave velocity – pulse wave velocity, expressed in meters per second, describes the speed at which the generated pressure wave travels through the arterial vascular system. Compared to the flow velocity, the pulse wave velocity is higher. The decisive parameter for the pulse wave velocity is the elasticity of the vessel. The more rigid the vessel wall, the faster the pulse wave. Thus, pulse wave velocity is a crucial factor in the assessment of arterial vessel stiffness, since the presence of arteriosclerosis significantly increases vessel stiffness. Pulse wave velocity is of critical importance because it is associated with increased patient mortality (mortality) when the velocity is significantly increased.
- Determination of augmentation index – augmentation index AIx represents a parameter of vascular stiffness composed of the difference between two different parameters, systolic blood pressure and diastolic blood pressure. According to recent studies, the determination of augmentation index can be used to improve the assessment of existing arterial damage.
- Determination of central aortic blood pressure – using the arteriograph, it is also possible to simultaneously determine central aortic blood pressure, which also has an impact on vascular stiffness. Elevated aortic blood pressure precedes elevated blood pressure in the brachial (upper arm) artery.
- Determination of the ankle-brachial index – the ankle-brachial blood pressure index (ABI) represents the quotient of systolic blood pressures measured at the lower leg and upper arm. The determination of this parameter allows the assessment of an existing peripheral arterial occlusive disease (pAVK; pathological narrowing of the arteries of arms and/or legs). With the help of this parameter, it is therefore possible to make statements about the lumen (opening) of the arteries in addition to the vascular stiffness. A quotient between 0.9 and 1.2 is considered physiological (healthy). However, if the ankle-brachial index falls below this value, an arterial circulatory disorder must be assumed. The ankle-brachial index correlates relatively precisely with the staging of pAVD according to Fontaine. If the ankle-brachial index falls below 0.4, there is an acute risk of necrosis (increased cell death) due to oxygen deficiency. Values above 1.3 are also pathological, as they indicate a sclerosis (calcification) of the media (arterial layer), which can occur, for example, in the context of diabetes mellitus.
Contraindications
There are no known contraindications.
Before the examination
Arteriograph examination is a noninvasive diagnostic method that does not require any preparation from the patient.
The procedure
The arteriograph represents a noninvasive procedure whose sensitivity in determining pulse wave velocity, central aortic blood pressure, and augmentation index surpasses both existing noninvasive and invasive procedures. With the help of the arteriograph, it is possible to provide evidence of unfavorable vascular changes at an early stage. Due to detection at an early stage, vascular changes that lead to stiffening of the arteries are partially reversible (can be reversed). The technique of the procedure is as follows:
- To calculate pulse wave velocity, differentiation between the initial and reflected pulse wave is necessary so that the determination of pulse wave velocity in the aorta can be accurately specified.
- Based on the calculation, statements can now be made about any arteriosclerosis present and about the endothelial function (inner lining of the vessels).
- From this, the biological vascular age can now be read on the basis of a standard curve. The threshold for the presence of end-organ damage is considered to be 10 meters per second, since the presence of a higher pulse wave velocity increases the probability of the occurrence of lethal (fatal) cardiovascular events.
After the examination
Following the examination, no action is required from the patient. Depending on the results of the examination, medication or other therapeutic measures may need to be performed.
Possible complications
Because arteriography using the arteriograph is a noninvasive procedure, no complications are expected.
