Pulse Volume Recordings

in Vascular Diagnostics and Imaging

Applied

Type

Modification

Confidence

92%

Created

Apr 26, 2026

Evidence

2 sources

Rationale

The stale guideline citation acc 2025 management is replaced by the superseding ACC/AHA guideline ACC/AHA (PMID 41252847), which covers the same recommendation regarding PVR utility in patients with diabetes or non-compressible vessels where ABI may be unreliable. Per the stale guideline replacement instructions, the newer guideline is preferred for the same claim rather than co-citing both. No other content changes are warranted as the existing text accurately reflects the clinical role of PVR.

Evidence

ACC/AHA. Management of Lower Extremity Peripheral Artery Disease: Guidelines From the ACC/AHA. 2026. PMID: 41252847.
Verified source
PubMedDOI
Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed.. 2022. Ch. 103, Acute Limb Ischemia: Evaluation, Decision Making, and Medical Treatment, p. 1689
10th ed.Latest verifiedCh. 103, Acute Limb Ischemia: Evaluation, Decision Making, and Medical Treatment, p. 1689
Textbook proof

In severe ischemia, ankle Doppler pressures are impossible to measure, partly owing to the lack of signal but also because of muscle tenderness. In less severe ischemia, an ankle pressure of 30 to 50 mm Hg can be expected, and an ankle–brachial index of about 0.3 is diagnostic of subcritical acute ischemia.

Content Changes

* Pulse volume recordings (PVR) provide waveform analysis of segmental volume changes.
* Flattened or dampened waveforms indicate significant peripheral artery disease (PAD).
* Advantage: not affected by medial arterial calcification. This makes PVR particularly useful in patients with diabetes or non-compressible vessels where the ankle-brachial index (ABI) may be unreliable [@svs2024-gornik] [@rutherford2018-rutherford][@rutherford-10e-2022-ch103-acute-limb-ischemia-evaluation-d-p1689-8bb6e374] [@acc2025-management].[@acc2026-c].
Go to section in textbookDispute / Submit evidenceAll updates