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We virtually always do segmental pressures for the first exam in our lab unless they have known or suspected infrainguinal stents (which we would not like to expose to suprasystolic extrinsic pressures with a cuff), in which case we do Doppler waveforms at all levels, but only measure the pressures at the ankles.  This allows us to supplement the information to allow us to speculate on the anatomic level of the disease. n fact some comment on the likely anatomic level of disease is an IAC requirement.  Dr. Kupinski I may misunderstand, but if I understand you correctly then I would respectfully point out that stopping with ABIs if they are abnormal makes it impossible to speculate on the anatomic level of the disease. On the contrary if the ABI and ankle Doppler waveforms are normal then you can say the resting study os normal and there is no particular reason to do full segmentals, although exercise still needs to be on the table.  IIn any case we always do great toe PPG waveforms and pressures. We do not do PVRs.  
For follow-up (including patients who have had open or endovascular interventions) we get the ankle Doppler waveforms and pressures (not full segmentals) along with toe PPG/pressure and a duplex scan of the treated segment/segments/graft.  
I would reiterate that we do not advocate PVR.  They are entirely qualitative and we prefer a quantitative test like a pressure index.  
Joe
 

On Mar 4, 2016, at 12:51 PM, Ann Marie Kupinski <[log in to unmask]> wrote:

Hi Wanda,
 
We will first do an ABI with multi-level PVR waveforms.  If the ABI is normal, then no segmental pressures.  If the ABI is abnormal then we add segmental pressures.
 
Ann Marie
 
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Wanda Ramos
Sent: Thursday, March 3, 2016 3:08 PM
To: [log in to unmask]
Subject: Segmental blood pressures
 
Good Afternoon to all:
I am inquiring how many of dedicated vascular labs are still performing segmental blood pressures as part of their protocol for lower extremity arterial physiological evaluation?
In so, what is your reference to still doing so?
 
 
Thank you and happy weekend to all!
 
Wanda
Non Invasive Vascular Lab-MCVI-BHSF
Miami, FL
 
 
 
 

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