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CAlcification can be tricky especially in the infrapopliteals.  But at least with duplex, you can tell if you are looking at a collateral, and many times even if the vessel will not show color, you can still obtain a doppler waveform. I would duplex any day over segs and pvr.  Much more specific, and accurate in my book.

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From: UVM Flownet on behalf of Myers, Ruth
Sent: Wed 1/21/2009 9:07 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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