Ann Marie,

I realize I tend to be very practical in my approach to vascular diagnostics
and that does not always make me very popular.  But when doing lower
extremity arterial duplex in "most" environments the most important things
to discern are; 
1: presence of disease 
2: severity of disease 

With number 2 there are two basic questions to answer, is it a stenosis
(stent), or occlusion (bypass).  Once that question is answered the
physician can determine and discuss appropriate treatment with the patient.
With that in mind we do peak velocity (pre stenosis/max) only, with ABI's.
Once a high grade stenosis is identified we do not place much emphasis on
any distal lesions, instead we shift our focus to determine
patency/occlusion of the vessel.  The last and equally important factor to
determine with an occlusion is status of the runoff vessels.  A great bypass
will fail if there is nowhere for the blood to go.  On the other hand, I
have many times identified patent distal vessels that did not fill on
angiography due to poor collaterals, which resulted in successful bypasses
that otherwise might have been medically managed till amputation.

Terry J Zwakenberg BS RVT RDCS


-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Anna Marie
Kupinski
Sent: Tuesday, September 06, 2005 1:29 PM
To: [log in to unmask]
Subject: arterial scanning

Hi all,

I have a question for those who do native arterial imaging.  What
hemodynamic parameters do you routinely measure?  We get a peak systolic
and end diastolic velocity but not too much else.  We will also measure
volume flow.  Depending on the circumstances, we also record the vessel
diameter.  Does anyone measure anything else, like PI, RI, and so on?

Thanks
Ann Marie

Ann Marie Kupinski, PhD RVT
Technical Director, Karmody Vascular Laboratory
The Vascular Group, PLLC
Albany, NY 12208
phone:518-262-5050
fax:518-262-6686

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