Disagree completely, no need to argue the point.Dr Jason Roberts (C) 954-801-2496(E) [log in to unmask] from my mobile phone, please excuse any typos
-------- Original message --------From: Patrick Doolan <[log in to unmask]> Date: 11/4/18 7:46 PM (GMT-05:00) To: [log in to unmask] Subject: Re: PVR with stents Dr Roberts,PVR is qualitative and not quantitative. There are no values obtained. Segmental pressures are quantitative. To address the question, I would do PVRs over stents. I wouldn’t do a segmental pressure over a stent because of safety and there is no value-added information obtained. I love arterial physiological exams and I’m surprised that they are only popular in the East and some of the Midwest. The PVR gives information on the quality of overall blood flow, and can elucidate how well collateral blood flow is helping overall perfusion. You may see collaterals on duplex, but is there any qualitative information obtained?The quality of the duplex exam, and the quantitative velocities obtained, is dependent on the quality of the technologist. The same for the physiological exam, but the quality seems a little more apparent if the information doesn’t agree. The arterial physiological exam and then an arterial duplex seems to be a great check and verification of the quality of both exams.I felt like jumping into the fray.Patrick Doolan On Sun, Nov 4, 2018 at 7:02 PM Andrew Bebry <[log in to unmask]> wrote:PVR will last forever. On Sun, Nov 4, 2018, 6:47 PM Sarah Sarlo <[log in to unmask] wrote:Our lab routinely performs PVRs over stent but not pressures even though many stents now are self-inflating.Sent from my iPhoneOn Nov 4, 2018, at 3:17 PM, Luz Guzman Restrepo <[log in to unmask]> wrote:In our lab Patients with Bpg/stent We do segmental pressures and ABI.If bpg/stent involves a tibial artery we do segmentals and tbi.On Nov 4, 2018, at 4:29 PM, Schneider, Joseph MD <[log in to unmask]> wrote:
Hello
We do not do PVRs in our lab (this seems to be a favorite in the Northeast, probably the lingering influence of John Mannick and Jeff Raines, we are Midwestern and likely are still influenced by Jimmy Yao
and Eugene Strandness) so I would like to ask how labs approach the problem of pressure cuffs in subjects with previous interventions, especially with stents. We would not do full segmental pressures in such patients and would limit pressure measurements to
the ankle (ABI) to avoid possible compression of the treated/stented arteries. I am wondering if those of you who use PVR (where the base pressure of 65 mmHg is much less than would be required in segmental pressure measurements) limit your PVR measurements
to the ankle and foot to avoid any compression of the stents?
Thanks
Joe
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