PVR's+and+Segmental+Pressures



Michayla: There appears to be disease on the right leg, most likely in the upper thigh region, possibly in the right internal iliac artery or right common iliac artery. In addition, there may be disease on the left leg below the knee but above the ankle. Also, it possible that there is disease above the left toe but below the ankle.

Emily: This patient has mild disease on the left leg at the high thigh, low thigh, popliteal, and toe, due to the loss of the dichrotic notch. There appears to be moderate to severe disease at the Lt. ankle. The whole right leg appears to have disease throughout the leg, moderate disease at the high and low thigh and severe disease below the knee, ankle, and toe.

Jen: Immediately, the drop in pressures on the right caught my attention. There was a drop of more than 20mmHg from right brachial to high thigh, which indicates disease or severe narrowing between these two levels. The difference between the contralateral sides also confirms this. The decreased pressures and ABI of 0.31 (<.9) on the right correlates with the waveforms seen (severe disease). Disease may be seen with duplex imaging between the iliac bifurcation and the SFA.

Jen: The above shows normal segmental pressures - no disease present. This can be determined by looking at the triphasic waveforms and the ABI's >.9.

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Jen:

[] -- this website is a great reference for PVR/segmental waveforms.

Tatyana: I agree with Jen that the image above shows normal PVR results - not only by looking at the waveforms and ABI's, but also noticing that there is no difference in segmental pressure readings between segments on the same extremity as well as between left and right sides.