First, I would like your opinion on the use of spectral doppler vs pvr. I
feel pvr is very succeptible to artifact from pt movement, central venous
overload, etc. Second, there is great use for duplex scanning in patients
whose kidneys cannot tolerate contrast. This was used with great success
in a nearby university I worked at and a detailed scan is still cheaper
than an angio with renal complications.
steve bernhardt wrote:
> I am from the Vascular Lab/Surgery dept. at Ochsner Medical
> Institutions. We feel that an ABI or segmental pressures with volume
> pulse recording is the only true method of determining the
> physiological function of the lower extremity on a routine basis.
> Color flow evaluation of the lower extremity does not take into account
> collateralization and should only be use for pseudoaneurysms, graft
> evaluation or possibly to evaluate the site of an angioplasty or stent
> placement. It seems that there are institutions out there that use
> this as a revenue enhancing device. As quoted from the HCFA criteria
> for noninvasive vascular studies, "Duplex scanning and physiologic
> studies may be reimbursed during the same encounter if the physiologic
> studies (ABI) are abnormal." And if the ABI is abnormal why perform a
> duplex exam when an angiogram will be done to plan for bypass, PTA, or
> stent placement?
> p.s. susan your comments were eliquently put!
> --- Susan Rish <[log in to unmask]> wrote:
> > Hi everyone!
> > I'm wondering how many labs are doing LEA duplex
> > instead of LEA segmental
> > BP/PVR studies on a regular basis. Are there
> > documented interpretation
> > guidelines? I'm told that, at least in my part of
> > the country(Southeast),
> > PVR is still the most accepted and expected test
> > done for claudication or
> > anything other than a graft or R/O pseudoaneurysm.
> > Any info anyone could
> > give me on the subject would be appreciated,
> > including reimbursement
> > comparisons.
> > Susan Rish, RT, RDCS, RVT
> > P.S.
> > This is the first time I've written in to the
> > Flownet although I've been a
> > reader for about a year now. This is really a great
> > forum, but please
> > don't harrass me if I've misspelled anything or
> > asked a stupid question. ;-)
> > Also, Diana R., the Soundwave is great. I recommend
> > both of these to every
> > tech and M.D. I meet.
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