Simultaneous arterial pressure traces are recorded from a radial artery catheter and a femoral artery catheter in the same patient with normal compliance vessels. Which comparison is correct?

• A Femoral systolic pressure is higher and femoral diastolic pressure is lower than radial, with nearly identical mean pressures ✓
• B Femoral systolic pressure is lower and femoral diastolic pressure is higher than radial
• C Radial systolic pressure is higher because of proximity to the aortic valve
• D Femoral mean pressure is significantly lower than radial mean pressure

Explanation

Distal pulse wave amplification occurs as the arterial pressure wave travels peripherally: reflected waves add to the forward wave, sharpening the systolic upstroke and raising peak systolic pressure at more distal sites such as the femoral and radial arteries compared with the aorta. The pulse pressure therefore widens distally, so femoral systolic exceeds radial systolic and femoral diastolic is lower. Mean pressure is essentially preserved along the arterial tree, eliminating options B and D.

Reference: Miller's Anesthesia, 9th ed.

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