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Ok, now let us make a few comments based upon your responses.
1.  To go directly from an abnormal ABI to angiography would be justifiably
criticized.  Much like proceeding directly to mastectomy after feeling a
lump in the breast.  Now, if there are no pulses, a cold foot , and a
necrotic toe, . . . then that is something else.
2.  The other responders are quite right, . . . it is a long running debate
about duplex testing vs physiologic testing and which is better under what
circumstances.  I personally like segmental pressures with PVR's before and
after exercise.  Other people hate that and prefer other testing.  Hopefully
your physician is exercising good clinical judgment and is not just ordering
testing indiscriminately and wasting your resources.  Whether your testing
is unnecessary or not should be addressed with follow-up and comparisons
with angiography, etc.  The stuff we all do for continuing quality
improvement.
marcus

-----Original Message-----
From: Marika Klesic [mailto:[log in to unmask]]
Sent: Tuesday, March 05, 2002 8:22 AM
To: [log in to unmask]
Subject: Lower Extremity Duplex



Can the Flownet members please let me know when and where it is appropriate
to duplex lower ext. native arteries? I am working with a physician who is
ordering them on every patient with any abnormal ABI result's. It seems like
I am doing unnessecary procedure's and I can not find any protocols listing
appropriate testing parameters.

                Thank you for your help!

                               Marika Klesic RDCS




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