Diagnosing Lower Extremity Arterial and Venous Disease
Early diagnosis of lower extremity arterial disease can help prevent serious complications; immediate treatment can improve your ability to walk and even save a limb.
Arterial and Venous Doppler Ultrasound
A Doppler ultrasound uses sound waves to produce images that highlight blood flow in the leg arteries and veins. This test detects and evaluates any blockages caused by plaque buildup. It is also used to look for Chronic Venous Insufficiency. Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs.
During the ultrasound, the doctor places a handheld instrument called a transducer on your skin, transmitting sound waves that produce images of the leg’s blood vessels on a monitor. The procedure can take 30 to 60 minutes and does not cause any pain. Afterward, you can typically return to your regular activities.
Ankle-Brachial Index or Blood Pressure Testing
Peripheral Artery Disease (PAD) is a major public health issue, and the Society of Interventional Radiology recommends greater screening efforts through the use of the ankle-brachial index (ABI) test.
The ABI is a simple, painless test that compares the blood pressure reading in the arm and ankle. It is a direct measure of fatty plaque buildup in leg arteries and an indirect gauge of plaque accumulations throughout the entire cardiovascular system.
The blood pressure in your arms and ankles is checked using a regular blood pressure cuff and a special ultrasound stethoscope called a Doppler. The pressure in your foot is compared to the pressure in your arm to determine how well your blood is flowing and whether further tests are needed.
Because atherosclerosis is a systemic disease, individuals developing plaque in their legs are likely to have plaque building up in the carotid arteries, which can lead to stroke, or the coronary arteries, which can lead to heart attack. Early detection of PAD is important because these individuals are at significantly increased risk, and preventive measures can be taken.
An individual with an ABI of 0.3 (high risk) has a two- to three-fold increased risk of five-year cardiovascular death compared to a patient with an ABI of 0.95 (normal or low risk).
CT / CTA
Computed Tomographic (CT) Angiography is non-invasive test uses X-ray and contrast agent (dye) to create pictures of blood vessels in the arteries in your abdomen, pelvis and legs. This test is particularly useful in patients with pacemakers or stents. This painless test typically takes 10 to 15 minutes to complete.
A peripheral angiogram is a test that uses X-rays and contrast dye to help your doctor find narrowed or blocked areas in one or more of the arteries that supply blood to your legs and feet.
The peripheral angiogram helps your health care professional decide if a surgical procedure is needed to open blocked arteries.
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For additional information on angiography, you can visit The American Heart Association.