Noninvasive Evaluation of the Diabetic Extremity (The Vascular Laboratory)

In determining which mode of treatment or operation to undertake , clinical judgment is stillmore valuable than noninvasive tests . However in cases where clinical judgment leaves question , the non -invasive laboratory results may be extremely important , especially when they support the clinical impression. The noninvasive laboratory may be of value in differentiating an ischemic from a neuropathic origin of pa in or ulcerat ion in a pulseless foot . A neuropathic pat ient may develop arterial occlusions and so no longer have palpable pulses, but may have excellent collateral circulation . The vascular laboratory is of undisputed value in detecting major areas of thrombophlebitis (above the knee) as well as evaluation of the carotid circulation . Description Systolic blood pressures are taken with cuffs placed at appropriate areas (thigh, calf, ankle) with aDoppler used to listen to arterial flow at the ankle.