Evaluation and Diagnosis
A thorough medical history and physical exam, along with an assessment of risk factors will be performed. Several diagnostic tests are available to confirm the presence of PVD and determine the appropriate course of treatment. Most of these tests are noninvasive and painless.
- Pulse Volume Recordings (PVR)
A PVR study is a noninvasive vascular test in which blood pressure cuffs and Doppler are used to get information about arterial blood flow in the arms and the legs. This information is then used to determine the presence, severity and general location of peripheral vascular disease.
- Ankle-brachial index (ABI)
ABI is a comparison of the blood pressure in the ankle with the blood pressure in the arm using a regular blood pressure cuff and a Doppler ultrasound device. To determine ABI, the systolic blood pressure (the top number of the measurement) of the ankle is divided by the systolic blood pressure of the arm.
- Single-level ABI: Cuffs are placed on the upper arms and at the ankles while a Doppler (probe) is placed on the pulse at the feet to hear the sound of the artery. A loud, rhythmic whooshing sound corresponds with every heartbeat. As the cuffs are inflated, the sound disappears and slowly returns as the cuff is deflated. This provides a baseline reading.
- Multi-level ABI: (Also called segmental ABI.) In addition to the arms and ankles, cuffs are placed on each calf, above the knees and at the thighs. This reading will help pinpoint where in the arteries the blockages occur.
- Stress ABI: Used for patients complaining of intermittent claudication. After the multi-level ABI is performed, the patient is placed on a treadmill for 5 minutes, or until they are unable to continue walking. Pressures are recorded as soon as possible after ending the exercise.
[top of page]
|
Peripheral Vascular Disease 