ABI's
What is a normal ABI reading?
>0.90
True or False
Cuff size does not affect segmental pressure readings.
False- If cuff is too small you will have a falsely elevated reading
PVR is used in the LE to measure blood ___________ changes with each pulse in a part of the limb
Volume
What is the term used for an inadequate seal of the proximal or distal wall that allows blood flow into perigraft region.
Endoleak
With compression technique, how long are the cycles of compression?
15-20 minutes
TRUE or False
The systolic pressure at the ankle is usually higher than the systolic pressure in the arm
True
The primary purpose of segmental pressures is:
Determine the location of obstruction(s)
Picture 1. Where is the disease?
Left Pop
Name a complication that can occur with bypass grafts
•Endoleak
•Graft infection
•Embolization
In an ischemic leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause the leg to turn white, what is this known as?
Elevation Pallor
A decrease in ABI of ________ compared to the previous exam can indicate graft stenosis.
>0.15
A pressure gradient that is greater than _____ would be considered abnormal
20-30mmHg
Where is the disease? Image 2
Normal reading
What type of graft would be put in if the patient has a distal aorta occlusion?
Aorto-Bi Femoral
What size is the pseudoaneurysms when it has a risk of rupture?
>3cm
During an ABI exam the pressure should be inflated 20-30mmHg after the last ____________ __________
Audible Sound
What volume do we record when taking segmental pressures? Systolic or Diastolic
Systolic
Where is the disease? Image 3
Right Iliac
Name 3 different types of bypass grafts
•Synthetic polytetrafluoroethylene (PTFE) graft
•Synthetic Dacron
•In situ vein graft (fem-pop or fem-tibial)
•Reversed vein graft
A color jet can be visualized in the lumen when there is a _________.
Stenosis
True or False
ABI readings are likely to be affected by calcification.
True it will increase the ABI exceeding 1.40
Doppler Segmental pressures are usually done in combination with ___
PVRs (and PPG)
When looking at PVRs what are we observing?
Waveform contour (shape)
Amplitude changes
Describe the In-situ vein graft procedure.
•The procedure uses the great saphenous vein for arterial conduit. The vein is left in place or “in situ”.
•The valves are taken our and perforating veins and communicating veins are ligated and cut.
Graft failure and infection are likely to be seen in this location, this is why we pay close attention when scanning after a bypass surgery.
Anastomosis Site
Give a reason why a patient may have disease present in their lower extremities even if their ABI is greater than 1.0
Good Collaterals
Calcification
Diabetes
Segmental pressure drops typically indicate the obstruction is either at the cuff or _________
Proximal
If a Popliteal obstruction is interpreted from a PVR exam which cuff would have been used to determine this finding?
Calf
In stenosis the velocity will at least _____ the pre-stenosis segment
Double
Many __________ may enter at the distal end of occlusion to reconstitute the artery.
Collaterals