It is our lab's policy never to perform an ABI on a patient that has a
positive DVT.   Some of you "old timers' may remember that we used 40
mmHg pressure in order to compress the veins for outflow studies. In
performing arterial pressures you exceed this pressures three fold. This
would obviously induce changes which could in fact result in an emboli
moving cephalad. Why would you bother when you can do an arterial duplex
to obtain your answer along with a toe pressure.
Barbara Pizzo, BS. RVT
Manager, PVL, EEG and Cardiology Services
St. Joseph Medical Center
Reading, PA 19605
610 378 2802

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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