Pulse Volume Recordings

What are pulse volume recordings?

A pulse volume recording, or a PVR test, measures blood flow in your legs. It uses ultrasound (high-frequency sound waves) to evaluate circulation in your arteries. A PVR test is painless and noninvasive, so it doesn’t require any needles or cuts in your skin. It’s also called pulse volume plethysmography or a segmental pressure test.

When are pulse volume recordings performed?

Your healthcare provider may recommend a pulse volume recording to diagnose or assess peripheral artery disease (PAD). PAD develops when the blood vessels carrying blood from your heart to your legs get too narrow. It’s usually the result of atherosclerosis (build-up of cholesterol and plaque in your arteries).

PVR tests can help locate blood clots or other blockages in your legs. If you have unexplained leg pain when walking, your healthcare provider may order a PVR test to check for blockages.

Sometimes a PVR can also help diagnose:

• Artery disease in the arms or fingers.
• Thoracic outlet syndrome (TOS).

Are pulse volume recordings the only way to evaluate PAD?

A pulse volume recording is one type of noninvasive vascular test. Your healthcare provider may recommend a PVR test in combination with:

• Ankle-brachial index (ABI): ABI is the most common test for PAD. A healthcare provider places blood pressure cuffs on your ankle and compares the pressure to blood pressure in your arms. It’s very similar to PVR, but PVR measures pulse volume at more points along the leg. It also gives more accurate results in people with calcified (hardened) arteries due to diabetes or chronic kidney disease.
• Arterial duplex ultrasound: A healthcare provider uses a handheld tool to apply high-frequency sound waves to your lower extremities. The results show narrowed or blocked areas. Unlike PVR, this test doesn’t measure blood pressure.
• Exercise stress test: You may walk on a treadmill so your healthcare provider can measure the blood pressure in your lower extremities before and after exercise. You might have an exercise stress test if your resting PVR test results are normal, but you still have unexplained symptoms such as leg pain with exercise.

Who performs a pulse volume recording?

Healthcare providers called vascular technologists or sonographers usually perform PVR tests and other noninvasive vascular testing. Sometimes a nurse performs your PVR test.

How do I prepare for a pulse volume recording?

You don’t need to do anything special to prepare for a PVR test. Your healthcare provider may ask you to stop taking certain medications or avoid smoking before the test.

What happens during a pulse volume recording?

You remove your clothes and jewelry and change into a hospital gown before your PVR test. You won’t need any anesthesia or sedation because the test is painless and noninvasive. A PVR test typically takes between 30 and 60 minutes.

Be sure to let the technician know if you have had any previous treatments for vascular diseases, such as a stent, angioplasty or bypass procedure.

During a pulse volume recording:

• You sit upright on a padded exam table.
• A healthcare provider places blood pressure cuffs on your big toes, ankles, calves, upper and lower thighs and arms. They also apply a special gel to your skin, which helps with the ultrasound.
• They inflate the cuffs to measure your blood pressure. You’ll feel the cuffs tighten, but you shouldn’t experience any discomfort.
• In some cases, your provider asks you to walk or stand on your tiptoes.
• With the cuffs inflated, the healthcare provider uses a handheld device called a transducer to apply ultrasound waves to different parts of your leg.
• The sound waves measure the speed and volume of blood moving through your legs. The results appear on a computer monitor as “waveforms.” Your healthcare provider looks at the shape of the waveforms to evaluate blood flow.

What happens after a pulse volume recording?

You can go home after your PVR test and resume normal activities.

What are the risks of a pulse volume recording?

A PVR test is a safe, noninvasive procedure that doesn’t carry any serious risks.

When should I know the results of a pulse volume recording?

The vascular technician or sonographer works with a physician to evaluate and interpret the results. This may take anywhere from a few hours to a few days. Ask your healthcare provider when you can expect your results.

What do the results of a pulse volume recording mean?

Your healthcare provider compares the blood pressure in your legs to the blood pressure in your arms. If the blood pressure is lower in your legs than in your arms, you may have arterial disease. Your provider also compares the pulse among parts of your leg to identify the general location of blockages or narrowed arteries. A PVR test does not indicate which specific arteries are affected.

What questions should I ask my healthcare provider about pulse volume recordings?

You may want to ask your healthcare provider these additional questions if your PVR test results are abnormal:

• Am I at risk for a blood clot if I have PAD?
• How accurate are the results of a PVR test?
• What are my treatment options for PAD?
• Will I need additional tests, such as imaging exams?

A note from Cleveland Clinic

A pulse volume recording, or PVR test, is a noninvasive vascular test that measures blood pressure and the rate of blood flow in the arteries of your legs. It’s a common test to diagnose or assess peripheral artery disease (PAD). The results of a PVR test can help your healthcare provider plan additional testing or treatment.