Dear Terry,
Our brachial artery reactivity testing (in adolescents/kids) is giving us negative numbers and many outliers, incontrols and those with disease.  We have tried 3 different operators with the same results over the last 3-4 years. Therefore, we have decided it is not operator, but could be related to the methodology or the patient.  Traditionally, I measured intima to intima.  More recently, I have retrospectively, trace measured intima to intima and media to media.  I suspect the result will be the same.
I was reveiwing your attached email from Flownet.  You suggested scanning the brachial artery in the lower arm- are you saying below the elbow- ulnar or radial?  Are you occluding cuff then in the upper arm (above the elbow)?  Do you think this could be our measurement methods?
Thank you, 
Connie McCoy, RVT
Cincinnati Children's Hospital

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