Case Studies

All three professional groups (sonographer, podiatry and nurse) would assess dorsalis pedis, posterior tibial, peroneal, popliteal and common femoral arteries. However, the vascular nurse would be assessing peroneal to decide vascular surgery options; in podiatry, the expert podiatrist would be informing the full vascular tree to aid in diagnosing peripheral arterial disease; the sonographer would assess peroneal as part of the vascular assessment.

All agree the pulsatile waveform can give an indication of peripheral arterial disease, where triphasic and biphasic pulse sounds are relatively healthy in the absence of any other arterial disease symptoms and a monophasic pulse may indicate arterial disease.

Vascular Podiatrist: “Doppler sounds are to be put in context of all clinical findings, I’m not going to exclude peripheral arterial disease on a biphasic pulse… We do find reduced ABPI with biphasic pulse sounds… If we’ve got symptoms of claudication and biphasic signals and normal ABPI, we would then perform an ABPI post-exercise.”

Vascular Nurse: “If we find a normal ABPI and biphasic pulse sounds we would discharge.”