Print

Print


Good reply.  I thought you might have something to add...

----------
> From: Terrence D. Case <[log in to unmask]>
> To: [log in to unmask]
> Cc: [log in to unmask]
> Subject: Re: Incompressible vessels
> Date: Wednesday, January 22, 1997 9:39 AM
> 
> Colleagues;
> 
> The issue of incompressible vessels raises another issue that has become 
> near and dear to me; that is, what are the alternatives available to the 
> technologist when ankle pressures are unrelaible or deemed 
> "incompressible"? Clearly, the toe pressure is a viable option but 
> published studies of the accuracy of this test, are somewhat dubious.
> 
> Last year, this laboratory presented a works-in-progress using 
> oscillometric pressures to assess periperal arterial pressures. The 
> oscillometric method, does not require  vessel closure and 
> therefore is capable of obtaining pressures in patients with
incompressible 
> vessels. Sergio tells me he has been using this technique for years but 
> the only published materail was in January 1997 issue of JVS.
> 
> Another intersting study is called the "pole test". With this test, one 
> needs only a Doppler, tape measure and a reference chart to obtain 
> pressures in the ankles (no BP cuff). The pole test, utilizes the 
> principles of hydrostatic pressure to determine absolute ankle pressue. 
> While listening to a pedal pulse and at the same time  raising the leg of
a the 
> patient in the supine position, the technologists measures the height of 
> the limb at the point the Doppler signal ceases and the length of the 
> limb from the inguinal ligament to the pedal signal site. A chart is then

> used to coordinate a point that relates to a pressure. With our limited 
> experience so far, we have been impressed with the apparent accuracy of 
> this test but plan to perform more formal research. A real benefit of 
> this test is that it works well in patients with low ankle pressures (<50

> mmHg). 
> 
> In sum, it is practical to arm the vascular technologists with reliable 
> alternatives to the traditional Doppler derived ABI's. I look forward to 
> hearing about your experience of this common dilema we are are often
faced 
> with.
> 
> Terry Case
> University of Vermont