SVU On Demand Webinar 051426: Lower Extremity Arterial Physiologic Testing-Lower Extremity Arterial Physiologic Testing

Video Transcription

Video Summary

This webinar, hosted by Laurie Lizansky for the SVU Learning Educational Committee, focused on lower extremity physiologic testing, a cornerstone of vascular lab evaluation that remains important even in the era of duplex imaging. Presenter Marguerite Marlowe, a highly experienced vascular technologist and nurse, reviewed the clinical history, examination techniques, and interpretation of Doppler signals, segmental pressures, and pulse volume recordings (PVRs).<br /><br />Key teaching points included the importance of obtaining a careful patient history—especially details about pain, tissue breakdown, and whether symptoms suggest acute limb ischemia or chronic arterial insufficiency. Marlowe emphasized distinguishing claudication from vasculogenic rest pain, identifying the difference between acute embolic/thrombotic occlusion and chronic progressive atherosclerotic disease, and recognizing urgent “six Ps” findings.<br /><br />The presentation also covered practical exam technique: exposing the legs fully, checking pedal pulses and skin temperature, listening to Doppler signals correctly, applying cuffs with proper sizing and positioning, accounting for hydrostatic effects, and using PVRs to assess flow when calcification makes pressures unreliable. She explained how waveform phasicity reflects distal resistance, how pressure gradients help localize disease, and how toe pressures are useful when vessels are noncompressible.<br /><br />The session concluded with example case interpretations and a Q&A discussion addressing artifact control, gain settings, toe pressure technique, skin color assessment in patients of color, and the value of PVRs in tandem SFA lesions.

Keywords

lower extremity physiologic testing

vascular lab evaluation

duplex imaging

Doppler signals

segmental pressures

pulse volume recordings

acute limb ischemia

chronic arterial insufficiency

toe pressures

claudication

PVR waveform interpretation