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I think it is also important to point out that PVR's are going to include any collateral flow,  and doppler signals are going to be vessel specific.  We always do doppler wave forms (Duplex and segs machine) and if they are fairly abnormal then we might tack on a PVR to demonstrate what collateral flow might be present.  Duplex should always be done on an abnormal ABI w/toe pressures.  Some labs might choose less then 1,  some might choose less than .9 or even less than .8.  Mostly its up to the physicians comfort level and his own clinical assessment that sets his protocol.
 Duane Williams R.V.S.
Technical Director 
Vascular Lab
North Dallas Surgical Specialists
972-487-6400 wk
972-800-3407 mobile
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From: "Benge, Claudia" <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, January 23, 2009 2:08:20 PM
Subject: Re: PVR's vs duplex


Ruth,
CW Doppler waveforms are very sensitive.  Your doc needs to go to an SVU interpretation course.
 
Claudia A. Benge, 
From:UVM Flownet [mailto:[log in to unmask]] On Behalf Of Myers, Ruth
Sent: Wednesday, January 21, 2009 10:08 AM
To: [log in to unmask]
Subject: Re: PVR's vs duplex
 
While we're on the subject, can anyone send me a protocol for lower extremity arterial duplex.  Our Lab uses PVRs, but our doc has a lot of trouble reading them and recommends MRA on everyone. When we bring up discorrelates in our QA meetings, all he says is that the PVRs are just supposed to be a screening exam, they really aren't meant to be specific about disease!  Also, how well does duplex work with calcified vessels ( which is where we have the problems with our PVRs/Segmental pressures.)?
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]]On Behalf Of Jeff Stanley
Sent: Wednesday, January 21, 2009 10:03 AM
To: [log in to unmask]
Subject: Re: PVR's vs duplex
We do not use PVRs but we do provide CW Doppler waveforms.  With duplex you are still getting waveforms so you could get by without PVR's.  I would add ABI's to the duplex exam.   As far as time for exam we allot 30 min for unilateral exam, 60 min for bilat exam.  And those are miminum times.  If there is disease at more than one level it'll take longer.
 
Jeff Stanley BS,RVT
The Surgical Clinic
Nashville, TN
 
 

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From:UVM Flownet [mailto:[log in to unmask]] On Behalf Of Angela M. Mulford
Sent: Wednesday, January 21, 2009 8:42 AM
To: [log in to unmask]
Subject: PVR's vs duplex
We have a new in charge physician who wants to eliminate PVR's and have arterial ultrasounds as the sole diagnostic tool.  He states that this study can be done in less than 10 min.!!.  I will refrain from sharing what I think at this time.  Has anyone totally eliminated PVR's in their practice, if so how is it working.  I will welcome any other thoughts.  Here is my work email if you would like to respond so as not to bog down the flownet.  [log in to unmask]  Thank you Angie 
 

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