| |
How to Perform a Segmental Pressure Study
|
| A Segmental Pressure is performed using the same method as an Ankle Brachial Index, but incorporates additional cuffs wrapped at the high thigh and above and below the knee, in addition to the ankle. Segmental Pressure studies are considered reimbursable when performed using a bidirectional Doppler with hard-copy output. Koven Technology non-invasive Doppler models Smartdop® 45, Smartdop® 30EX, Smartdop® 50EXF, and Bidop® 3 (when used with Smart-V-Link® Vascular Software) can be used to perform a reimbursable Segmental Pressure study. |
| Take a blood pressure reading at the arm |
|
- Place a blood pressure cuff around the patient's arm. Place ultrasound gel on the tip of the probe and apply the probe at a 45 to 60 degree angle over the brachial or radial artery.
- Wait for Doppler sounds to become stable. If your Doppler has an LCD display, watch the waveform on the display until it becomes rhythmic and stable.
- Inflate the cuff to 20 mmHg over pressure cessation. Then, slowly deflate the cuff until the first Doppler sound is heard.
- Record the systolic pressure when the first sound is heard and repeat the test on the other arm. Use the highest arm pressure to calculate the ABI to rule out subclavean steal syndrome.
|
|
Take the systolic pressures at the leg
|
|
Prior to taking the systolic pressures at the leg, take printouts of the Doppler waveforms at all cuff sites for documentation.
- Wrap appropriately sized blood pressure cuffs around each leg at the ankle, above and below the knee, and at the high thigh. Place ultrasound gel on the tip of the probe and apply the probe at a 45 to 60 degree ankle over the posterior tibial or dorsalis pedis artery.
- Wait for Doppler sounds to become stable. If your Doppler has an LCD display, watch the waveform on the display until it becomes rhythmic and stable.
- Inflate the ankle cuff to 20 mmHg over pressure cessation. Then, slowly deflate the cuff until the first Doppler sound is heard. Record the systolic pressure and repeat for the ankle cuff on the other leg.
- Repeat at the posterior tibial artery for the cuffs below the knee, the popliteal artery for the cuffs above the knee and at the femoral artery for the cuffs at the high thigh.
|
|
| Interpreting the Results |
|
- Observe pressure differences between adjacent cuff sites on the same leg. Pressure differences between cuff sites are used to localize the disease.
- Pressure differences between two adjacent levels of less than 20 mmHg is considered normal within limits ¹
- Segmental pressure tests should be combined with treadmill or reactive hyperemia studies to determine pressure recovery times.
¹ Weiss RA. Vascular Studies of the Legs for Venous or Arterial Disease. Dermatologic Clinics, Volume 12, Number 1, January 1994.
|
|
| The instructions provided above are intended as general guidelines. For specific instructions on performing a Segmental Pressure study using your Doppler, please refer to the operation manual provided. |
|
|
| |
Click here to view Koven Technology's privacy policy |
|
| |
Smartdop, Bidop, & Smart-V-Link are registered trademarks ® of Koven Technology, Inc., St. Louis, MO |
|
 |
|
|
|
|
Copyright © 2008 Koven Technology, Inc.
|
