Pulse Volume Recording in the Diagnosis of Peripheral Vascular Disease

Since its introduction in 1972, the measurement of pulse volume recordings (PVR) has become an integral part of vascular laboratory diagnostic testing. The PVR measurements are often the 1st vascular test performed on a patient with suspected peripheral arterial disease (PAD) of the upper or lower extremities. In contrast to duplex ultrasonography, which provides anatomic and hemodynamic information of extremity artery blood flow, the PVR is a functional, indirect physiologic exam that allows the clinician to correlate a patient’s symptoms with direct measurements of arterial pressure at different levels of the extremity. PVR test results can direct medical treatment, additional noninvasive testing, or angiographic-directed intervention. The instrumentation involved in measuring PVRs is straightforward, as is its interpretation for the diagnosis and classification of PAD. This chapter provides an overview on the indications for obtaining PVR studies, as well as a primer for study interpretation.