Vasc- peripheral artery testing PT 2 Flashcards
Protocol step 1?
bilateral ABI measurements
what is bilateral ABI measurements?
- ankle brachial indice: ankle.brachial systolic pressure
- BRA pressure- use highest systolic measurement of LT or RT arm
- RT leg- use highest of PTA or dorsalic pedis A
- LT leg- use highest of PTA or dorsalic pedis A
what does ABI give you an indication of?
- how much disease you may encounter
what measurement if indicative of little or no hemodynamically significant stenosis?
> 9.0
mild disease = ABI ?
0.8 to 0.89
moderate disease = ABI?
0.5-0.79
severe disease = ABI
<0.5
ischemis rest pain= ABI?
<0.3
ABPI=
highest ankle pressure/ highest brachial pressure
exam step 2?
- Bilateral exam is always performed
- Image the arteries from the groin to the proximal PTA/PER A and ATA(trif)
- The vessels at the ankle should be imaged and documented at the time of performing ABI measurements
color/doppler ratios?
- colour should be analyzed for aliasing
- doppler spectral tracings at all of the above levels if normal
- ratio measurements are taken at the sites of narrowing/aliasing
- PSV proximal to the stenotic zone and highest attainable PSV in the stenotic zone
- Angle correct of 60 degrees must be used for both: a ratio of >2 is hemodynamically significant(the higher the ratio the more severe the disease is)
- PST is also imaged and documented
normal velocity ratio?
<1.5:1
25-50% stenosis velocity ratio
1.5-2: 1
50-75% stenosis velocity ratio?
2-4: 1
> 75% stenosis velocity ratio?
4:1
pulsatility index decreases with?
abnormal biphasic or monophasic flow
pulsitility ratio (PI)=
Systolic (S)- minimum diastolic (D)/ mean (M)
normal pulsitily index?
4-13 (average 6.7)
reporting history?
HBP,high cholesterol,smoking,diabetes,heart disease,claudication
Note of ulcers and gangrenous digits
Diagram should indicate areas of stenosis and grading
ABI’s should be noted on technical impression form
Areas of monophasic flow,shading in areas of occlusion,indicating collaterals
