Vascular Services

Learning More About Your Blood Vessels

Vascular services deal with imaging of the body’s network of blood vessels, which includes the arteries, veins and capillaries that carry blood to and from the heart.

Carotid Duplex Doppler

This non-invasive test shows the anatomy of the carotid vertebral and subclavian artery, blood flow in vessels, narrowing or blockage of vessel and the degree of blockage, presence and location of plaque, Up to 90% of ischemic strokes originate from the carotid arteries and this simple non-invasive test can save many lives with early detection of disease.

What to expect during this exam:

Your sonographer will ask questions regarding your medical and surgical history. He or she will take your blood pressure in each arm and you will then be asked to lie done on the exam table with your head titled back. The test, however, can also be performed with you sitting up if necessary.

A small amount of ultrasound gel will be apply on the neck area. A transducer (ultrasound probe) is moved up and down each side of the neck and under the jaw to visualize each vessel. You will hear different sounds and see color images, each representing blood flow. Scan time can vary anywhere between 30 and 45 minutes.

Please do not wear necklaces and make sure to wear clothing that exposes the neck.

Resting ABI (Ankle Brachial Index)

This is a simple and fast test to measure blood flow in the legs by taking your blood pressure at the ankles and in the arm at rest. Ideally ankle pressure should be equal or greater than arm blood pressure when it is not this can indicate peripheral vascular disease.

Stress ABI

This test measures blood pressure at the ankles and in the arm in those patients complaining of leg pain during walking and their resting ABI was normal. This test is also use to differentiate between true and false claudication. First the test will be performed at rest and then again after exercising (5 minutes running on a treadmill). The purpose is to determine if the blood pressure drops in either ankle after exercise. If blood pressure drops after exercise it is suggestive of peripheral disease. There is no preparation necessary.

Upper and/or Lower Extremity Arterial Doppler Studies

The purpose of an Arterial Doppler ultrasound is to evaluate the blood flow to the upper extremities (arms) and/or lower extremities (legs) arteries and determine if there is blocked or reduced blood flow through these major arteries. This ultrasound is used to determine the location and severity of narrowing of the extremity artery, if a blockage is indicated. Often patients with the following symptoms are seen for this study:

  • Leg pain during walking (Claudication).
  • Feeling of numbness and tingling sensations in the hands, arms, feet and legs
  • A sensation of fatigue and heaviness in the arms and legs
  • Leg cramps

There is no preparation necessary.

Venous Studies (Upper extremity, Lower Extremity and Peripheral)

Through the use of Duplex Ultrasound technology, blood flow through the veins is evaluated. Color Duplex ultrasound involves the use of standard ultrasound methods to produce a picture of a blood vessel. In addition, a computer converts the Doppler sounds into two colors, red and blue, that are overlaid on the image of the blood vessel. These colors represent the speed and direction of blood flow through the vessel. This will take approx. 45 minutes.

A Venous Doppler study is used to demonstrate whether blood clots or slowing or complete block of blood flow, is present in the veins located in your arms or legs. These blood clots can break loose and could be life threatening. A dangerous condition known as pulmonary embolism can be caused if a clot such as this obstructs blood flow to the lungs. Symptoms that are investigated with Venous Doppler include:

  • Pain, heaviness or aching sensation in the arms and legs.
  • Swelling of an arm or leg
  • Skin reddening
  • Skin that is hot to the touch

There is no preparation necessary.

Abdominal Aorta & Iliac Artery Aneurysm Study

The aorta is the largest artery in the body, originating from the left ventricle of the heart and extending down to the abdomen and divides just above the belly button into two smaller arteries, right & left common iliacs (located in the pelvis). Abdominal aortic aneurysm (also known as AAA) is a ballooning of the abdominal aorta exceeding the normal diameter by more than 50 percent, and is the most common form of aortic aneurysm. General no symptoms are present, although occasionally they cause pain in the abdomen and back (due to pressure on surrounding tissues) or in the legs (due to disturbed blood flow). The major complication of abdominal aortic aneurysms is rupture, which can be life-threatening. An ultrasound will be performed to determine the diameter of the aorta as it descends from the heart to the abdomen. You will be required to fast over night if your test is scheduled in the morning or for at least 4 hours prior if scheduled in the afternoon.

Visceral (SMA & Celiac) Artery

Celiac artery (celiac trunk) originates from the abdominal aorta just below the diaphragm and supplies oxygenated blood to the liver, stomach, spleen, pancreas etc. The SMA (Superior Mesenteric Artery) is also a branch of the abdominal aorta and supplies blood to the intestine. Visceral artery disease is the narrowing of the arteries that supply blood to the intestines, spleen and liver. Atherosclerosis (the hardening of the arteries due to the build-up of plaque and fatty deposits that adhere to the artery wall) causes this narrowing which can result in a reduction in blood-flow to these organs. This reduction in blood flow can cause pain after eating and results in weight loss. It can also result in a fatal interruption of blood-flow to the intestines. An ultrasound will be used to determine if narrowing is present. You will be asked to fast overnight for this exam if scheduled in the morning.

Renal Artery Ultrasound

Renal Artery Ultrasound evaluates presence or absence of any narrowing of the artery which supply blood flow to the kidneys. This test also involves checking blood flow within the kidneys and is usually perform in those patients having recent history or difficulty in controlling their high blood pressure.

* Renal Artery ultrasound does require some preparation. (This preparation applies also to AAA, Iliac and Visceral Artery Ultrasounds)

  • For morning appointments, do not eat food or drink liquids after midnight the night before your exam.
  • For noon or later appointments, do not eat food or drink liquids 6 hours prior to your exam.
  • Do not smoke or chew gum prior to your exam as they can increase stomach gas.
  • Allow 1 hour of office time for this exam.
  • Patients can take their medication with little sip of water.

AV Fistula

An AV Fistula (arteriovenous fistula) is an abnormal connection or passageway between an artery and a vein. It may be congenital, surgically created for hemodialysis treatments, or acquired due to pathologic process, such as trauma or erosion of an arterial aneurysm. No preparation is necessary for this study. An ultrasound will be used to determine if a fistula is present. There is no preparation necessary.

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