Answers to your questions about
Peripheral Vascular Ultrasound Examination

Lower Extremity Arterial Evaluation
The purpose of a lower extremity arterial evaluation is to detect the presence, severity and location of atherosclerosis (narrowing of the arteries caused by plaque) in your legs. Some ot the indications for a lower extremity arterial evaluation include leg pain while walking (claudicatino), leg pain at rest, leg numbness and tingling, or non-healing ulcers or sores of the legs or feet. The lower extremity arterial evaluation includes the following components:

1. Pulse Volume Recordings and Segmental Pressures
Blood pressure cuffs are placed on the patient's thighs, calves and ankles (both legs). The blood pressure cuffs are then inflated slightly and waveforms as well as blood pressures are obtained. Blood pressures are obtained by using a special microphone, or Doppler transducer, to listen to the pulses at your ankles. This procedure is painless and takes approximately 30 minutes.

If the blood pressures and the waveforms are normal, it may be necessary for you to walk on a treadmill to determine the effects of exercise on lower extremity blood flow and blood pressure. If the blood pressures remain normal, no further testing is required. If the blood pressures drop, an ultrasound evaluation of the arteries will be performed.

Sometimes an exercise treadmill test is not required or cannot be tolerated by the patient. In these cases, an ultrasound scan of the lower extremity arteries will be performed without exercising the patient.

2. Exercise Treadmill Test
If a treadmill test is required, you will walk on the teadmill at a slow speed for five minutes or less. There will be a physician or nurse and a technologist present. An EKG will monitor your heart during the walk. You will be asked to report any symptoms such as leg pain or numbness, hip pain, chest pain or dizziness as soon as they begin. When you have completed the exercise, blood pressures in both legs are obtained.

If the post-exercise blood pressures in you legs are normal, no further testing is required. If the post-exercise blood pressures in your legs differ significantly from those at rest, an ultrasound scan of your legs will be performed.

3. Ultrasound Scan
An ultrasound scan is a painless procedure which uses high frequency sound waves that are bounced off structures and moving blood inside the body. Images and signals are produced which are used to evaluate arterial blood flow.

A water-based gel will be applied to your legs, and an ultrasound probe, or transducer, will be used ot scan the arteries in you legs. Images of your arteries and the sound of your blood flow will be recorded on videotape. This portion of the examination takes approximately one hour.

If all three portions of the arterial evaluation are performed, the evaluation could take 2 to 22 1/2 hours. There is no special preparation for a lower extremity arterial evaluation.

Lower Extremity Venous Duplex Scan
The purpose of a venous duplex scan is to detect the presence of thrombus (blood clot) in your veins. Some indications for a lower extremity venous scan include warmth, pain and swelling of one or both legs, or ulcers of legs.

Images of your veins and the sound of blood flow within them will be recorded using ultrasound (high frequency sound waves). A water-based gel will be applied to your legs and ultrasound transducer will be used to record the images. You will be asked to perform various breathing maneuvers and will feel compressions of your leg in several places throughout the test. This examination is usually painless, although you may feel some discomfort if your leg is tender. This procedure takes approximately 1 your to perform, and no special preparation is required.

Abdominal Aorta Duplex Scan
An ultrasound scan of your abdominal aorta is performed to detect aneurysms (weakening and stretching of the walls of the aorta). A water-based gel will be applied to your abdomen, and images of your abdominal aorta and the sound of blood flow through is will be obtained using and ultrasound transducer. These images will be recorded on videotape. This procedure is painless and will take approximately 45 minutes. It is necessary to fast (refrain from eating and drinking) for 6 hours prior to this procedure.

Carotid artery duplex scan
The purpose of a carotid artery duplex scan is to detect the presence of atherosclerosis (narrowing caused by plaque) in your carotid arteries, which ar the arteries in your neck that supply blood flow to your brain. Some indications for a carotid artery duplex scan include weakness, paralysis or dysfunction of limbs, change in speech, visual disturbances, numbness or tingling of limbs, and balance disturbances. Your physician may also order a carotid duplex scan if he detects a bruit (sound or murmur) when he listens to the blood flow in your neck with his stethoscope.

A water-based gel will be applied to your neck and an ultrasound transducer will be used to obtain the images and sound of your blood flow. This scan is painless and takes approximately 45 minutes to 1 hour. No special preparation is required for this examination.

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