I'm with Chris,
Our lab does a lot of PVRs/segmental pressures. If they're abnormal then we scan to clarify the location and extent of disease. As this lab works for a group of vascular surgeons, PVRs/segmental pressure testing is quite efficient to follow up many vascular procedures over time. I can easily blow through a complete plethysmography test in 15 minutes, (efficiently weeding out those who need a duplex scan or not) versus the scan time required to scan the entire arterial system. For patients with a normal plethysmography test, why scan every inch of their arteries? PVRs are a great tool to indicate an arterial problem before you even start to scan. They should clue you in to the probable location of disease. Although PVRs are limited in the sense that you can't specifically describe the extent and exact location of a stenosis, when combined with duplex scanning, it's tough to beat. With enough experience, and a complete test, you can usually accurately determine the level of any significant disease based solely on plethysmography testing. Some surgeons may look at plethysmography results to evaluate healing potential. I don't know that a duplex scan would yield this type of info. If someone has a rotten toe, a duplex scan won't tell you if it should heal. Although many tech's would rather just scan the arteries, is that really because PVRs provide no useful information, or is it just to big of a pain for some? Additionally, you can basically double the reimbursement if you complete a plethysmography test and (if abnormal) then scan the patient. Perhaps I'm biased because I enjoy the variety of tests we perform, PVRs included.
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Willis, Chris
Sent: Wednesday, January 21, 2009 11:58
To: [log in to unmask]
Subject: Re: PVR's vs duplex
I must be in the minority here. We average at least 12 per day. We exclusively perform pvrs/segmental pressures on 99% of patients with suspected arterial insufficiency of the legs. We do however, perform arterial duplex on post-op bypass grafts, as well as atherectomy-stenting patients in combination with pvrs.
Chris Willis RVT
Eastern Maine Medical Center
Bangor, Maine 04401
Phone: (207) 973-7471
Fax: (207) 973-7450
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