The Cooper Vascular Center

Vascular Imaging Services

Cooper Vascular Center utilizes the highly technical skills of imaging professionals to provide diagnostic testing and therapeutic services for patients.

Pulse Volume Recording

Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a disorder that occurs in the arteries of the circulatory system. Arteries are the blood vessels that carry oxygen and nutrient-rich blood from the heart to all areas of the body.

Healthy arteries have a smooth lining that prevents blood from clotting and promotes steady blood flow. In PAD, arteriosclerosis or “hardening of the arteries” occurs when the arteries slowly become narrowed or blocked when plaque gradually forms inside the artery walls. Plaque is made of excessive fat, cholesterol and other substances floating through the bloodstream, such as inflammatory cells, proteins and calcium. If the narrowing of the arteries  progresses to total blockage or closure (occlusion) of the vessel blood cannot get through to nourish organs and other tissues, causing damage to the tissues and eventually tissue death.The vessel walls become less elastic and cannot dilate to allow greater blood flow when needed (such as during exercise).  Inadequate blood flow to the lower extremity will always result in a non-healing wound, which often leads to infection, tissue loss and amputation.

Peripheral arterial disease (PAD) affects 12 million people in the United States.  More than half of the patients with PAD experience no symptoms. Those diagnosed with PAD have a 5 times greater risk for death due to heart attach and stroke.  Diabetic patients are at an even higher risk.

Pulse Volume recording is the first choice for detecting peripheral artery disease.

How The Test Works

Pulse Volume recording is an easy, non-invasive and accurate way to diagnosis and measure the blood flow within the blood vessels or arteries. Its purpose is to help locate blockages in the arteries. Physicians usually perform pulse volume recording on the legs to help diagnose leg artery disease. However, pulse volume recording may also be used in patients with suspected arm artery disease, thoracic outlet syndrome, or spasms of the finger arteries (Raynaud's disease).

What is an Ankle-arm Pressure Index (ABI)?

For the ABI, your physician measures your blood pressure in your ankle and in your arm. Your physician will compare the two numbers to determine your ABI. The ankle-arm pressure index (also known as the Ankle/Brachial Index or ABI) compares the systolic blood pressure of the ankle to that of the arm (brachial).

Normally, the blood pressures in your ankle and arm should be about equal. But if your ankle pressure is half your arm pressure (or lower), your leg arteries are probably narrowed.

These measurements are useful in the assessment, follow-up and treatment of patients with peripheral vascular disease (PVD). ABI's provide an objective baseline to follow the progression of the disease process and evaluate the effectiveness of the treatment plan.

To perform the ABI, your physician will use an ordinary blood pressure cuff and an ultrasound device. The ABI results are usually combined with Doppler or pulse volume waveform analysis.

Pulse volume recording demonstrating bilateral segmental pressure decrease across the superficial femoral arteries, significantly worse on the left side than on the right side. Note the mild dampening of the arterial wave form on the left, compared with the right. The ABI is consistent with mild disease on the right and moderate to severe disease on the left. Note the significant decrease following exercise. The resting ABI is calculated as 171/191 = 0.90 (right) and 112/191 = 0.59 (left). All calculations are based on the higher brachial systolic reading, which in this case is 191. The ankle systolic reading is based on the higher of the posterior tibial and dorsalis pedis systolic readings. (ABI = ankle-brachial index; PT = posterior tibial; DP = dorsalis pedis)