Segmental Pressure Studies
Segmental Pressure studies are performed using the same method as an Ankle Brachial Index but incorporate additional cuffs wrapped at various postions on the leg. They are used to evaluate blood flow and idenfy the location of blockages in the arteries of the leg.
Segmental Pressure studies are considered reimbursable when performed using a bidirectional Doppler with hard-copy output. Koven Technology noninvasive vascular Doppler models Smartdop® 45, Smartdop® 30EX, and Bidop® 3 (when used with Smart-V-Link® Vascular Software) can be used to perform reimbursable Segmental Pressure studies.
The Segmental Pressure Exam
A Segmental Pressure study is performed by placing the patient in a supine position and wrapping pressure cuffs around both arms and both legs at the various positions. Sites typically include the ankle, above and below the knee and the high thigh.
Using a noninvasive ultrasound vascular Doppler, pressures are taken at both arms, and at each position on the legs by inflating the pressure cuffs past the point where Doppler sounds cease, then slowly deflating the cuffs until Doppler sounds return.
Interpreting the Results of an Segmental Pressure Study
- 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.
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