Segmental Examinations with Cuff-Link Systems
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Product Information
Specifications:
- Product Name: simpleABI Cuff-LinkTM Systems
- Model: MAN-0009-D
- Manufacturer: Newman Medical
- Phone: 800-267-5549
Product Usage Instructions
Segmental Procedure:
Setting up:
To begin, open the simpleABI software by double-clicking the
icon on the computer desktop. Select File > New > 3 cuff
Segmental Report (or 4 cuff) to start a new report. Enter patient
information, risk factors, symptoms, and ICD codes as needed.
Attaching Cuffs:
Wrap the cuffs around each limb following the color-coding:
white connectors to the patient’s right side, blue connectors to
the left side. Connect green hoses to arm (or thigh) cuffs, blue to
above-knee cuffs, red to calf cuffs, and yellow to ankle cuffs.
Refer to the provided diagram for proper placement.
Ankle Waveform:
Press Next on the control unit to move to the ankle site. Press
and release the button with the Waveform image to inflate the cuff
to 85mmHg, deflate to 65mmHg, and hold. Ensure the patient remains
still during the waveform measurement.
Calf Pressure & Waveform:
Press Next to move to the calf site and obtain the arterial
pressure and waveform similar to the ankle procedure.
Above Knee Pressure & Waveform:
Proceed to the above knee site, follow the same process as for
ankle and calf measurements.
Thigh Pressure & Waveform (4-cuff):
If using a 4-cuff system, move to the thigh site and obtain
pressure and waveform measurements as before.
Left Side:
Repeat the pressure and waveform sequence for the left side of
the patient. Once completed, save or print the exam report.
Helpful Hints:
Efficient Protocol: Upper leg pressures may not be needed if
ankle pressures and PVR waveforms are obtained. This approach can
save time and increase patient comfort.
FAQ
Questions:
If you have any questions or need assistance, please contact
Newman Medical at 800-267-5549.
Date: 7/2025
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Segmental Examinations with simpleABI Cuff-LinkTM Systems
Please Read the Users Manual First: This is a quick reference guide.
Contraindications: Do not perform the exam on someone suspected of having acute deep venous thrombosis, and do not take an arm pressure in an arm with a shunt or dialysis graft.
Background: A segmental exam of the leg is an extension of the ABI exam. In this test, you can attempt to localize the site of an occlusion by taking the pressures and waveforms at more locations on the leg. Pressures and PVR waveforms are taken just as in the ABI exam. The Doppler probe location remains at the ankle usually the PT .
The Segmental Procedure
Setting up
Opening the exam On the computer desktop, double click the simpleABI icon. When the program opens select File>New>3 cuff Segmental Report (or 4 cuff). The report will open and you can enter patient information, risk factors, symptoms, ICD codes, etc.
Attaching cuffs Wrap the appropriate cuffs around each limb. White connectors to patient’s right side, blue connectors to left side. Green hoses to arm (or thigh) cuffs, blue to above-knee cuffs, red to calf cuffs, yellow to ankle cuffs. Reference the diagram below, noting that the image is reversed as if viewing the patient lying down.
Metal Bayonet Cuff Connectors
Color-Coded Plastic Connectors Blue – left side White – right side
Cuff-Link Control Unit with tubing properly attached
Brachial Pressure 1. Begin with the right brachial. Place the Doppler probe at a 45 degree angle to the skin over the radial or brachial artery. Use plenty of gel and slowly move the probe laterally until the best signal is obtained. 2. Press and hold Inflate on the Cuff-Link Remote (shown above) and inflate the cuff until you no longer hear the signal – continue for an additional 10-20 mmHg. 3. Release Inflate and the cuff will automatically deflate at the suggested rate of 2mmHg/second. 4. When you hear the Doppler signal return, pressing Pressure will be store the pressure value in the exam.
Ankle Pressures 5. Press Next on the remote and the system will move to the Dorsalis Pedis (DP) site. Find the arterial signal using the Doppler probe on the dorsalis pedis artery on top of the foot. Obtain the arterial pressure in the same manner you did on the arm. (Hold Inflate until occlusion, release Inflate, press Pressure on Doppler signal return) 6. Press Next and the system will move to the posterior tibial (PT) site. Find the Doppler signal on the posterior tibial artery. Obtain the arterial pressure. (Hold Inflate until occlusion, release Inflate, press Pressure on Doppler signal return)
Ankle Waveform 7. Press Next and the system will move to the waveform site. Press and release the button with the Waveform image on the top right of the remote. The cuff will inflate to roughly 85mmHg and deflate to the proper pressure (65mmHg) and hold that while the waveform is obtained. The waveform will start to appear when the cuff has reached 65mmHg. The patient should remain as still as possible during the measurement.
Continued on next side… Questions? Newman Medical 800-267-5549
7/2025
MAN-0009-D
The Segmental Procedure (continued)
Leave the Doppler probe on the posterior tibial (PT) for all upper level site pressures, if upper pressures will be taken. See notes on efficient protocols below.
Calf Pressure & Waveform 1. Press Next on the remote and the system will move to the calf site. Obtain the arterial pressure and waveform in the same manner you did on the ankles.
Above Knee Pressure & Waveform 2. Press Next on the remote and the system will move to the above knee site. Obtain the arterial pressure and waveform in the same manner you did on the ankles.
Thigh Pressure & Waveform (4-cuff) 3. Press Next on the remote and the system will move to the thigh site. Obtain the arterial pressure and waveform in the same manner you did on the ankles.
Left Side 4. Repeat the above pressures and waveform sequence for the left side of the patient. When finished, save or print the exam.
Helpful Hints
Cuff techniques: Wrap the cuff snugly. Cuffs may be placed over thin clothing or stockings. Don’t let the patient try to help by lifting their leg – as they relax their muscles the cuff will become loose. Placing a pillow under the patients heels may aid the examination. Have the patient remain as still and quiet as possible while taking the waveforms. If the patient has tremors that interfere with the waveform, having them perform a few dorsiflexions with their toes before taking the waveform may help.
Doppler techniques: Hold the probe like you would a pencil, close to the end. Move the probe back and forth laterally over the artery to obtain the best signal. Support the probe with your hand resting on the patient so that the probe does not move as the cuff is inflated and deflated. One of the keys to a successful exam is being able to keep the probe in place as you inflate and deflate the cuffs. If the probe moves, you may not be able to hear the Doppler sounds return and may have to repeat the inflation
Efficient Protocol: Current clinical and CPT guidelines for code 93923 do not require that pressures be obtained at upper sites on the leg if the exam is performed using both ankle pressures and PVR waveforms. This may significantly reduce the time necessary for this exam while maintaining clinical value. This efficient protocol significantly increases patient comfort. Clinically, if the ankle ABI is unequivocally normal, the upper leg pressures will be normal as well.
Questions? Newman Medical 800-267-5549
7/2025
MAN-0009-D
Documents / Resources
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simpleABI Segmental Examinations with Cuff-Link Systems [pdf] Instruction Manual Segmental Examinations with Cuff-Link Systems, Examinations with Cuff-Link Systems, Cuff-Link Systems |