Pulse Volume Arterial studies (PVR) identify changes in leg blood volume. Waveform pattern recognition is used to detect the presence and/or severity of arterial disease. Pulse Volume Recordings (PVR's) are considered reimbursable when performed using a bidirectional Doppler with hard-copy output. Koven Technology Vascular Doppler models Smartdop® 45, and Smartdop® 30EX can be used to perform reimbursable Pulse Volume Recordings (PVR's).

The general method of interpreting PV arterial waveforms is by pattern recognition.

A normal PV arterial waveform will display:

1. A rapid rise in the upstroke during systole
2. A sharp peak at maximum amplitude
3. A gradual downstroke following peak amplitude
4. Usually the presence of a dichrotic notch

The first sign of possible abnormality is the absence of the dichrotic notch. More significant occlusions will show a decreased slope of the ascending and descending segments and a rounding of the systolic peak. More serious obstructions will show flattened waveforms.

It is important to note that arteries located lower on the leg will produce sharper waveform peaks, while those located higher on the leg will produce more rounded waveforms.

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