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To be sure, there's no protocol for post-exercise toe pressures, but the fact that the toe pressures/indices are reduced after the exercise seems to suggest some degree of proximal disease. (The toe indices are normal or near-normal at rest.) So I don't think you can state there's no evidence of LE arterial stenosis. 

I also would like to know Doppler character, keeping in mind as noted in another message that the waveforms are unlikely to be bouncy—triphasic—in stiff pipes.

Don Ridgway






-----Original Message-----
From: UVM Flownet on behalf of Chris S.
Sent: Wed 1/7/2009 11:43 AM
To: [log in to unmask]
Subject: Re: Giving results on Toe pressures, when doing an LE seg. pressure exam
 
Thanks [log in to unmask]

So then if an arterial duplex is performed, and there is no stenosis visualized, 
but simply calcific shadowing seen along the walls of the large vessels.  And 
still, triphasic waves are seen.  Then how would you interpret the results?

Personally, I would probably say something like this:

No evidence of arterial stenosis in the large vessels of the lower extremities 
bilaterally.  The ankle brachial index is unreliable due to non-compliant 
(calcific) vessels.  Note is made of decreased toe pressures, suggestive of 
small vessel disease.

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