I have seen this a few times, also, where the flow initially comes back retrograde and then a few seconds later reverts to antegrade. I always used the first retrograde peak with my reasoning the same as previously stated by others, that from an interventional standpoint, arterial flow is arterial flow. I was trained this way in cases where the flow is definitely retrograde to begin with (verified with a quick duplex check). If I remember correctly the DPA flow was retrograde and the PTA pressure was higher anyway, so we just noted that retrograde flow in the comments.
PS Sorry if this is a duplicate message. I initially replied through gmail instead of the bulletin board.
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