space.template.ABI+CHART


 * || ABI || ABI with exercise || Segmental Pressures || CW Doppler || PVR’s ||
 * What you do for Exam…. || Short version of Segmental Pressure

-Take Brachial pressure -Only take ankle pressure at DP and PT || Leave Cuffs on Treadmill -10-12% incline -Walking for 5 min or as long as they can make it, or until they have symptoms -Walking at 1.5 to 2.0mph ** THEN ** -Get them back to the table quickly, and take pressures asap, taking legs first. || Tells us: //__Where the disease is__// ** 4 cuff or 3 cuff methods ** (+metatarsals+toe pressures) you need to Doppler distal to the cuffs Blow cuffs up higher then the BP -we know we went high enough when we can’t hear the signal anymore || Look at: -CFA -Mid SFA -Pop -DP -PTA || Good for calcific arteries (non-compressible-can’t get segmental pressures on, or just to double check)

Auto inflate to 60mmHg Measures Volume Change during systole || ** High thigh cuff artifact ** -may artifactually show high pressure, because we cannot inflate our cuff high enough to cut off blood, or we do not use a big enough cuff. ** -Cuff needs to be 20% bigger than the limb diameter! ** WE CAN -Believe low pressures -Not high pressure || Most people think that this is not necessary -Helpful for people with calcific arteries, because you cannot evaluate as easily with the other options || __ Qualitative View of Arteries __ Evaluating waveforms Compare side to side
 * Extra Facts ||  || Will take brachial pressures again as well, because they can change with exercise too! || __ Quantitative View of Arteries __

Toe PVR = PPG Waveform || <0.9 = pain with exercise <0.5 = Pain with rest (multi level disease) <0.3 = severe disease || After exercise it is normal for BP to increase. After exercise in a person with disease the pressure will decrease. || Toe pressures(TBI-toe brachial index): <0.6 is abnormal
 * Values || >0.9 = normal

Difference of 15-30mmHg (side to side/ sup to inf) is Abnormal || Need to be aware that this is very sonographer dependent and we can make things that are normal look abnormal with a bad angle || __ Normal __ -dicrotic notch-)should see all the way down the leg) -Triphasic -Short acceleration time __ Abnormal __ -1st sign of disease is loss of dicrotic notch -tardus parvus waveform || If they don’t have claudication…then you are done. ||  ||   ||   ||   || If you have someone <0.5 then do segmental pressures. ||  ||   ||   ||   ||
 * What to do if Normal || If they have claudication…then ABI with Exercise
 * What to do if Abnormal || If they are between 0.9 and 0.5 they should do an exercise ABI