Last time I heard,,
all medicare patients who have a duplex arterial scan require an ABI and
the PTA and DPA waveforms have to be demonstrated, by the CW or duplex.
The ABI has to be printed out by the machine, not hand written...
The ABI has to be done the same day as the scan...
It is neglect if not. ABI is the gauge for PAD management, before and after intervention, surgery or other means. It is also a separate charge.
Non compressible, diabetics require a toe pressure or metatarsal cuff.
Denise Levy, RVT, RDMS, RDCS

On Fri, May 7, 2010 at 8:14 AM, Ruhland, Greg F. <[log in to unmask]> wrote:
good question, answer for me is, one our lab performs and ABI on every patient who has a duplex, unless there is a specific reason not to. Two, the duplex is not as quantitative on a patient with stenosis  ( I can't spell, or type well, ignore my spelling). that said I feel it is great alternative if a given patient has loss of pulse secondary to swelling, but still has great Dopplers. 
   Greg 
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Randy Troyer
Sent: Friday, May 07, 2010 10:35 AM
To: [log in to unmask]
Subject: Re: TO ABI OR NOT TO ABI...

Why not do a arterial duplex and avoid the issue?

 

From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Ruhland, Greg F.
Sent: Friday, May 07, 2010 9:52 AM
To: [log in to unmask]
Subject: TO ABI OR NOT TO ABI...

 

Hey everyone,
   I always read the flow but I don't always participate, I feel the interested in what we might have to say about this subject.

   My lab has co-medical directors, interventionalist and vascular surgeon. The question was brought up… do you perform an ABI on a patient positive for DVT. A fairly heated discussion followed from 3 surgeons and 1 interventionalist very firmly divided on the subject. For all the obvious reasons. Possible to cause P.E., the need to know of arterial complications. Would an ankle pressure really be enough to cause P.E., Blah blah, blah. We all know there are good arguments for both schools of thought.

  What do you think, and does your lab have a set protocol? ( I think it should be different depending on each particular case, extent of DVT, other complications…ect.

  Just wondering if it will spark the same intensity of debate for one side or the other.
     Greg Ruhland RVT
  

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