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What Does "Significant Negative Pressure Gradient..." Mean?
Question: Have been trying to reach a doctor to discuss PAD testing results but have been unable to contact anyone. Could you please explain what Significant negative pressure gradient between the distal right thigh and right calf suspicious for distal SFA/popliteal disease means.
Brief Answer:
There is obstruction in SFA and Popliteal artery.
Detailed Answer:
Hello Nursing416
Thanks for writing to HCM
Significant negative pressure gradient between the distal right thigh and right calf means pressure difference in arteries supplying these two region is too high and it may be due to arterial obstruction.Obstruction involves SFA(superficial femoral artery) and popliteal artery which is causing excessive gradient.Popliteal artery is an extension of SFA.
Report doesn't mention exact site of possible obstruction.
Please upload full report for better interpretation.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
There is obstruction in SFA and Popliteal artery.
Detailed Answer:
Hello Nursing416
Thanks for writing to HCM
Significant negative pressure gradient between the distal right thigh and right calf means pressure difference in arteries supplying these two region is too high and it may be due to arterial obstruction.Obstruction involves SFA(superficial femoral artery) and popliteal artery which is causing excessive gradient.Popliteal artery is an extension of SFA.
Report doesn't mention exact site of possible obstruction.
Please upload full report for better interpretation.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Remainder of Report reads as follows: Procedure ART PVR-ABI COMP UE/LE BILAT-The study demonstrates tri-phasic arterial waveforms throughout the entire right lower extremity. Using 24mm HG negative pressure gradient between the distal right thigh and the proximal right calf. The ankle brachial index remains within normal limits at 1.1. slight decrease in amplitude of the pulse volume recordings is noted at the level of the right calf and right ankle. My left foot gets cold and bottom of toes turn blue at times only when I am sitting. I then elevate the foot and color returns back to normal quickly. I just dont understand what's going on. Could there be a slight blockage because of the slight decrease in pulse volume. If so what would be the treatment? I really appreciate your help. Thank you.
Hi Doctor: I forgot to mention to you that I was paralysed on my right leg in the past and get numbness feelings many times even though I can walk, I do have foot drop and cannot move my foot and ankle to the right only to the left and cannot move
Hi Doctor: I forgot to mention to you that I was paralysed on my right leg in the past and get numbness feelings many times even though I can walk, I do have foot drop and cannot move my foot and ankle to the right only to the left and cannot move
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
Main finding is slight decrease in amplitude of arterial waves at the level of right calf and right ankle.This is not very significant finding and slight decrease in amplitude may be due to slight obstruction at proximal level means at the level of SFA(superficial femoral artery) and popliteal artery.It is good that all arteries of lower limb shows normal triphasic pattern.
You shouldn't be worried.Your condition can be well managed by medicines.
It is important to know history of hypertension,diabetes mellitus,dyslipidemia.
Hypertension,dyslipidemia,smoking etc are the major causes of peripheral vascular disease.
So,you need few investigations like routine hemogram,Random blood sugar,Lipid profile,Liver function test,Renal function test.If there is any derangement then it should be corrected because it can cause further progression of obstruction.
Besides treatment of underling disease you may need vasodilators depending upon clinical conditions.
Your symptoms are typical of peripheral vascular disease but paralysis doesn't occur in this disease.You need proper neurological assessment.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
Main finding is slight decrease in amplitude of arterial waves at the level of right calf and right ankle.This is not very significant finding and slight decrease in amplitude may be due to slight obstruction at proximal level means at the level of SFA(superficial femoral artery) and popliteal artery.It is good that all arteries of lower limb shows normal triphasic pattern.
You shouldn't be worried.Your condition can be well managed by medicines.
It is important to know history of hypertension,diabetes mellitus,dyslipidemia.
Hypertension,dyslipidemia,smoking etc are the major causes of peripheral vascular disease.
So,you need few investigations like routine hemogram,Random blood sugar,Lipid profile,Liver function test,Renal function test.If there is any derangement then it should be corrected because it can cause further progression of obstruction.
Besides treatment of underling disease you may need vasodilators depending upon clinical conditions.
Your symptoms are typical of peripheral vascular disease but paralysis doesn't occur in this disease.You need proper neurological assessment.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much doctor for putting my mind at ease. I am scheduled for CBC; CMP and Lipid profile and also will schedule an MRA. I guess this was a good thing to find it early enough so it can be treated with medicine and not angioplasty. Do you think I can continue with my daily routines such as exercise walking and lifting. I do heavy lifting on my job. Why does my foot get cold then turns blue at times when I am sitting. I elevate it then it goes quickly back to normal color. Is this peripheral artery disease? Please advise.
Thank you so much for answering all of my questions.
Thank you so much for answering all of my questions.
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
You should go for thorough investigations as it can detect the underlying cause.
You don't require any surgical intervention at all.Your condition can be well managed by medicines.
Mild obstruction in artery is causing your symptoms.
You should continue your daily activities.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
You should go for thorough investigations as it can detect the underlying cause.
You don't require any surgical intervention at all.Your condition can be well managed by medicines.
Mild obstruction in artery is causing your symptoms.
You should continue your daily activities.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
Hi Doctor:
You have been so helpful throughout this whole situation with negative pressure gradient stemming at the SFA. I did receive my labs and my total cholesterol is 187; BS 87; LDL 105; CBC levels are all normal. Do you think this still warrants and MRA? I am clostaphobic. Please advise. Again thank you for your help and fast replies.
You have been so helpful throughout this whole situation with negative pressure gradient stemming at the SFA. I did receive my labs and my total cholesterol is 187; BS 87; LDL 105; CBC levels are all normal. Do you think this still warrants and MRA? I am clostaphobic. Please advise. Again thank you for your help and fast replies.
Brief Answer:
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
It is relieving that your all blood parameters are within normal limit.
But,you should go for MRA as it will screen vascular structures of your lower limb.
It will be very helpful in proper evaluation and management.
Claustrophobia can be countered by premedication with anxiolytics like tablet alprazolam.It will relieve your anxiety.You should try to be calm during the process.You can close your eyes and enjoy soft music during MRI.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Please find detail answer below.
Detailed Answer:
Hello XXXX
Thanks for writing back
It is relieving that your all blood parameters are within normal limit.
But,you should go for MRA as it will screen vascular structures of your lower limb.
It will be very helpful in proper evaluation and management.
Claustrophobia can be countered by premedication with anxiolytics like tablet alprazolam.It will relieve your anxiety.You should try to be calm during the process.You can close your eyes and enjoy soft music during MRI.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. Indu:
Thank you so much for your help. It is greatly appreciated. I will schedule an MRA as soon as I can and will let you know out I make out.
Thanks again and have a great day.
Thank you so much for your help. It is greatly appreciated. I will schedule an MRA as soon as I can and will let you know out I make out.
Thanks again and have a great day.
Brief Answer:
Don't worry.You will be fine.
Detailed Answer:
Hello XXXX
Thanks for writing back
Don't worry at all.You should go for MRA.You will be fine.
Thanks for your comments.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Don't worry.You will be fine.
Detailed Answer:
Hello XXXX
Thanks for writing back
Don't worry at all.You should go for MRA.You will be fine.
Thanks for your comments.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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