Blood Flow Restriction/ Kātsu Training

Is the cuff properly aligned and designed for the much larger leg? (assuming this is the "lower limb" you refer to)
Yes it is. The cuff is designed for upper- (arm) and lower- (leg) limb and thus is a bit cumbersome to apply to the upper limb with one hand!
It is a well known systematic error in all cuff based blood measurement that using a too small cuff, tend to overestimate the blood pressure.
Yes it’s an issue we’re made aware of in clinical practice, especially with increasingly obese individuals. The cuffs are much narrower than clinical pressure cuffs so they tend to bulge at the sides as the pressure was pumped up on the lower limb. I’ll use reported data for lower limb pressure and adjust it by feel. Not ideal but needs must.
 
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