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Hi Matt,
I think we need to to take  signs and symptoms along with resting  
Doopler/PVR and ABI into account. If the patient presents with a good  
story for claudication and there is an ABI < .90, The result of  
exercising will be perfectly predictable. It will get worse. In this  
case the exercise test tells you nothing that you could not have  
predicted. Exercise should be reserved for those patients who present  
with an ambiguous hx and a normal resting Doppler/PVR/ABI. In most  
patients, a little bit of careful history taking can sort out the true  
claudicants from the spinal stenosis and DJD patients. If you have a  
patient who has a good sounding story for claudication with a normal  
resting study, that is a good indication for exercise. I have never  
been able to figure out what more there is to learn by exercising a  
patient who has an abnormal resting study.
Jeff
On Sep 22, 2008, at 4:09 PM, David Dashman wrote:

> Hello everyone,
>
> It seems there is a new trend in the peripheral vascular testing  
> world concerning Pulse Volume Recording's. Many facilities are  
> choosing to perform ABI's pre and post workout instead of taking the  
> more traditional PVR approach when testing for lower extremity  
> vascular disease. Does anyone know if this will take the place of  
> PVR's or if they will slowly become unnecessary? Please please  
> please shed some light. Thanks,
>
> Dave
>
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