Peripheral Arterial Evaluation Flashcards

A patient with an ABI of 0.55 complains of calf pain after walking one block. Which classification best describes this patient's peripheral arterial disease severity?

Answer: Moderate PAD

An ABI of 0.41–0.70 with claudication at short distances indicates moderate PAD.

During a lower extremity arterial duplex exam, you detect a peak systolic velocity (PSV) ratio of 4.2 at the superficial femoral artery. What does this ratio indicate?

Answer: 75–99% stenosis

A PSV ratio greater than 4.0 at a stenotic segment indicates 75–99% diameter reduction.

Which waveform pattern is expected at the common femoral artery in a normal, resting adult patient?

Answer: Triphasic with reverse flow component

The normal resting common femoral artery waveform is triphasic with a reverse flow component during early diastole.

A patient's toe-brachial index (TBI) is 0.55. What is the most appropriate clinical interpretation?

Answer: Abnormal — suggests significant digital arterial disease

A TBI below 0.70 is considered abnormal and indicates significant reduction in digital perfusion.

When performing segmental limb pressures, which cuff placement helps distinguish aortoiliac disease from femoral disease?

Answer: High-thigh and above-knee cuffs

A gradient between the high-thigh and above-knee cuff pressures localizes disease to the aortoiliac or femoral segment.

Which finding on plethysmographic waveforms most strongly suggests arterial obstruction proximal to the recording site?

Answer: Rounded peak with slow upstroke and absent dicrotic notch

A rounded, blunted waveform with slow upstroke and loss of the dicrotic notch indicates proximal obstruction reducing pulsatile flow.

A duplex scan shows the popliteal artery has a PSV of 180 cm/s with post-stenotic turbulence. The adjacent normal segment PSV is 60 cm/s. What stenosis category does this represent?

Answer: 50–74% stenosis

A PSV ratio of 3.0 (180/60) with post-stenotic turbulence classifies the lesion as 50–74% stenosis.