What is Vascular Disease?
The two main types of vascular disease are aneurysmal disease and obstructive disease. In aneurysmal vascular disease, the wall of a weakened blood vessel balloons out. This can lead to the formation of blood clots or even rupture. Obstructive vascular disease is the disruption of the normal flow of blood through the blood vessels usually as a result of atherosclerosis, the accumulation of fatty plaque in the walls of arteries. Patients with atherosclerosis are at increased risk for stroke and heart attack as well as claudication (painful cramping in the legs with walking).
Why are You Being Sent for a Specific Vascular Imaging Test?
Non-invasive tests: Only requiring office visit for ultrasound testing.
- Carotid Doppler: There are several reasons your doctor may have ordered a Carotid Doppler, including but not limited to: dizziness, fainting, strokes, mini-strokes (TIAs), previous carotid artery surgery (carotid endarterectomy) or stenting, or he or she may have heard an extra soundin the artery of the neck called a carotid bruit. It is important to identify significant obstruction in these arteries early, since blockages in these arteries can lead to stroke.
- Abdominal Aortic Ultrasound: Abdominal Aortic Aneurysm screening is recommended for men between the age of 65 and 75 years with a smoking history or for patients with first degree relatives with a history of an abdominal aortic aneurysm. The test can be used both for original identification as well as to follow aortic aneurysms/dilatations.
- Peripheral Arterial Doppler and ABI: Reduced blood supply to the legs may cause pain/cramping with walking, early muscle fatigue, as well as buttock discomfort. Patients that are diabetic or have smoked are at particularly increased risk for this problem. If you have symptoms or findings on physical exam, you may be referred for an ankle-brachial index or ABI. If your ABI is abnormal, you will likely be referred for the Peripheral Arterial Doppler. A Peripheral Arterial Doppler study may also be ordered for those patients who have already been treated for peripheral arterial disease with a graft or stent. Ultrasound evaluation of the treated area is part of the follow-up procedure. This is done to ensure that the graft or stent remains open and to try to identify any potential problems before they occur.
What Happens During these Tests and What Do They Show?
Vascular Ultrasound Testing. You will lie on your back on a comfortable examination table. To improve the quality of the pictures, gel is applied to the area of the body where the transducer will be placed. A sonographer moves the transducer over the area of interest to obtain different views of the arteries. He or she may ask you to change positions. You may also be asked to breathe slowly or hold your breath in order to maximize the image quality. This noninvasive procedure uses ultrasound to produce images of blood vessels and to provide information on the speed with which blood travels through the vessel. This information allows the detection of plaque or narrowing of the vessel.
Ankle-Brachial Artery Index. This test combines a traditional blood pressure cuff and Doppler ultrasound (without imaging) to compare the blood pressure in a persons arms to the blood pressure in the legs. A blood pressure cuff is inflated around a persons upper arm or lower leg to temporally cut off blood flowing through the artery, while the transducer is placed below the cuff on the artery. The cuff is deflated, and the reading on the blood pressure gauge is recorded at the moment the Doppler picks up a sustained signal, indicating normal blood flow through the artery. This procedure is done for both arms and legs. The higher of the two arm systolic pressures is compared to each foot systolic pressure to get an ABI for both the right and left leg. Ideally, the pressures in a persons arm and ankles will be roughly the same. A value of 1.0 is normal and values below 0.9 may indicate that vessels in your lower extremity are blocked.
How should I prepare for each test?
- Carotid Doppler, ABI & Lower extremity Arterial Doppler: No preparation is required.
- Evaluation of Iliac stent: This is a special situation if you have had an iliac artery stent as to best see it, one should not eat or drink after 12:00 midnight.
- Abdominal Aortic Ultrasound:
- Do not eat or drink after 12:00 midnight prior to the test, except water with prescribed medications.
- Diabetic patients: If on insulin: Take ½ dose of your prescribed dose the night before and morning of the test.
How Long Does It Take?
A thorough examination usually takes 30 minutes for a Carotid Doppler, 10-15 minutes for an Abdominal Aortic Ultrasound, 30-45 minutes for a Peripheral Arterial Study, and 5-10 minutes for an ABI.
Is the ultrasound Safe?
The echocardiogram is very safe and painless.
Our cardiologists read the studies and the results are conveyed to referring physician.