What is a Pulse Volume Recording Study?
A pulse volume recording (PVR) study is a diagnostic test used to evaluate blood flow in the arteries of the extremities, such as the arms and legs. It is a non-invasive procedure that helps assess the presence and severity of peripheral arterial disease or other vascular conditions affecting blood circulation in the limbs. A PVR study is also called pulse volume plethysmography or a segmental pressure test.
Indications for Pulse Volume Recording Study
Pulse volume recording study is often recommended to help diagnose or assess peripheral artery disease.
Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a common vascular condition in which blood supply to the limbs is reduced due to the narrowing of arteries. PAD is caused by the accumulation of fat, calcium, and cholesterol in the arterial wall (atherosclerosis), resulting in reduced blood flow - and therefore oxygen - to the limbs.
Types of Pulse Volume Recording Study
There are several types of pulse volume recording studies, including:
- Ankle-brachial index (ABI): This test compares the blood pressure in your arm with the pressure in your lower leg. Blood pressure cuffs are placed on your arms and ankles while your physician uses the Doppler to listen to blood flow. Blood pressures in your arm and ankle generally are equal, but a pressure in your ankle that is less than that of your arm could be a sign that your leg arteries are narrowed.
- Exercise Testing PVR: During this test, you will walk on a treadmill until symptoms appear, at which point blood pressure cuffs will be placed on your arms, thighs, calves, ankles, and feet. While you walk, your blood pressure will be recorded in each limb to help your doctor determine the location of a narrowed or blocked vessel.
- Thoracic Outlet Testing: During thoracic outlet testing, blood pressure cuffs are placed on the patient's upper arms. The test is performed while the patient is sitting in a chair. The technologist will move the patient's arms in different positions and take a blood pressure measurement at each position.
Preparation for Pulse Volume Recording Study
You do not need to do anything special to prepare for a PVR test. Your healthcare provider may ask you to stop taking certain medications or avoid smoking before the test.
What Happens During Pulse Volume Recording Study?
Pulse volume recording study is typically performed by a specially trained technologist and interpreted by a vascular medicine physician. In general, the study involves the following steps:
- You will usually be asked to wear comfortable clothing that allows easy access to the limbs being examined.
- You may be asked to lie down on an examination table.
- Blood pressure cuffs are placed on various parts of the arms and legs. The number and location of the cuffs depend on the specific type of PVR study being conducted.
- A small amount of water-soluble gel is applied to the skin over the area to be examined.
- A Doppler ultrasound probe is used to detect blood flow and measure blood pressure in the arteries.
- The Doppler probe emits sound waves that bounce off red blood cells, allowing the technician to assess the speed and direction of blood flow.
- The blood pressure cuffs are inflated one at a time, briefly restricting blood flow in specific segments.
- As the cuffs deflate, the technician monitors the return of blood flow, recording the pressure changes and velocity using the Doppler ultrasound.
- The pressure and flow measurements are recorded at various points along the arteries to create a pulse volume recording waveform.
- The recorded waveforms are analyzed to identify any abnormalities in blood flow, such as blockages or narrowing of the arteries.
- The results help diagnose conditions such as peripheral arterial disease (PAD) and provide information on the location and severity of vascular issues.
What Happens After a Pulse Volume Recording Study?
Once the PVR study is complete, you can go home and usually resume normal activities without any significant downtime.
What are the Risks of a Pulse Volume Recording?
A PVR test is a safe, painless, and non-invasive procedure that does not carry any serious risks. Some minor potential risks may include temporary discomfort or mild bruising in the areas where the cuffs are applied and allergic reactions to the gel used on the ultrasound probe.
