"If ABI and exercise are normal, that doesn't rule out some plaque being in
there, it just rules out stenosis major enough to cause symptoms (even with
increased demand, which is what the exercise is about). Doing segmentals
won't add information to that, and could just muddy the water if there are
Agree wholeheartedly, Don!
I feel that segmentals are old hat and usually useless, especially in the
populations we serve predisposed with bokuu medial calcification. The newer,
less invasive modernized choices of subsequent clinical correlative value, ex;
(MRA Angiography) says that our job nowadays is really for us to find and
document hemodynamically significant DZ. ABI's/TBI's below .7 need not apply
for exercise. STUDY OVER! MRA TO FOLLOW. NEXT PATIENT, PLEASE. And a
post-exercise ankle pressure/toe pressure drop of more than 20% resting
pressure should answer most diagnostic challenges as well. STUDY OVER! MRA
TO FOLLOW. NEXT PATIENT, PLEASE.
Perform then a Duplex Doppler? Wellllllll, I'd love to and I miss em'.....then
enjoy the watch-n-wait for the MRA/Angio confirmation of my work. Good old
days of edu-maca-shun and self-prompted clinical correlation!
I think the present lower extremity non-invasive examination should be
updated and standardized. Do I sound like a madman to anyone?
And by the way, Daigle rocks.
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