ARTERIAL LOWER EXTREMITY Possible symptoms: Claudication versus pseudo-claudication syndrome. Ischemic rest pain versus neuropathy. A need for amputation to predict level of healing. Non-healing leg lesions. A need for post-operative evaluation of arterial procedures, i.e., embolectomy, bypass grafting, etc. Impotence. Procedures Performed: SEGEMENTAL DOPLER PRESSURES obtained at four locations on the leg. A significant drop of pressure between the two segments pinpoints the obstructing lesions. TREADMILL STUDIES performed if the cardiopulmonary status permits. The patient may be put on a treadmill at 1.5 mph until claudication occurs. Patients demonstrating normal resting pressures, but with hemodynamically significant lesions, will drop their ankle pressures after exercise. The severity of the drop and time to recover also indicate the severity of the lesions. ANALOG WAVE FORMS obtained to assist in determining the location and extent of the lesions in the periphery and the pelvis. SEGMENTAL PLETHYSMOGRAPHY/PULSE VOLUME RECORDING (PVR) may be performed whenever noncompressible vessels are encountered. PVR also helps to determine the degree of collateral circulation. DIGIT PHOTOPLETHYSMOGRAPHY performed to evaluate small vessel disease. PENILE PERFUSTION and ARTERIAL RATIO INDICES taken to determine ratio. A ratio of less than 0.6 indicates a significant decrease in blood flow to the penis. COLOR ULTRASOUND/POWER DOPPLER images of the blood flow to indicate possible blockage. If you or your family members have any questions please feel free to contact Ohio Valley HeartCare at (800) 26-HEART.

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