Vascular Lab

Peripheral Arterial Study
The first investigation of peripheral arterial disease is segmental pressures, measuring the ankle/brachial pressure indices. This is combined with Doppler waveform analysis and Treadmill exercise testing if indicated. Segmental arterial pressures combined with Doppler waveforms and treadmill exercise is the most accurate and cost effective method to screen for peripheral arterial occlusive disease.

Ankle/Brachial Index >/= 0.90-1.00 Normal Asymptomatic obstruction disease. Also referred to as minimal disease. 0.50-0.90 Moderate Disease. <0.50 Severe Arterial Disease

Indications: (not all listed)
  • Claudication
  • Limb Pain
  • Rest Pain
  • Ulceration of the extremity
  • Non-healing ulcer
  • Decreased pedal pulses


    Extracranial Cerebrovascular Duplex Exam
    Carotid arterial assessment using non-invasive real time ultrasound scanning combined with Doppler color and spectral analysis is fast becoming the test of choice in determining hemodynamic occlusive disease. In fact, with the aid of experienced Vascular Technologist, many Vascular Surgeons are now performing surgery based on duplex findings without the need for angiography and therefore avoiding its complications.

    Carotid duplex scanning is a cost effective and very accurate screening test and gives the surgeon valuable information on the degree of stenosis and the type of plaque present. The vertebral arterial circulation is also assessed.

    Spectral Analysis of carotid lesions are classified in 5 major groups:
    1. 0-39% Stenosis Minimal Plaque-non- Significant.
    2. 40-59% Stenosis Moderate Plaque-Moderate Significance.
    3. 60-79% Stenosis moderate to severe Plaque- Significant. Patient may need surgical intervention if symptomatic.
    4. 80-99% Stenosis Severe. Significant volume flow reduction. Probable surgical intervention.
    5. Occluded.

    Indications:
  • Cervical Bruit
  • TIA
  • CVA
  • Amaurosis fugax
  • Follow up after carotid endarterectomy
  • Non-lateralizing, less specific symptoms, may include dizziness, headaches and vertigo.
  • Suspicion of Pulsatile mass in carotid or subclavian region.
  • Suspected subclavian steal syndrome (BP <20 mmHg in contralateral arm)


    Abdominal Duplex Scan The abdominal vasculature is now relatively easy to image with the latest ultrasound technology. Aortoiliac and renal arterial studies are routinely performed in our Laboratory. With proper patient preparation (NPO after midnight) our lab has a high accuracy rate for predicting aneurysmal, mesenteric, and occlusive disease of the aorto-iliac segments with precise location.

    Indications:
    Renal Duplex
  • Renal Failure
  • Follow up post surgery
  • Hypertension (refractory to medical management)
  • Hypertension (new onset)
  • Patients who are outside normal age for hypertension
  • Screen for renal artery stenosis

    Aortoiliac Duplex
  • Abdominal Aortic Aneurysm
  • Hip or buttock Claudication
  • Diminished pulses
  • Emboli resulting in ischemic digits
  • Monitoring of aorto-iliac arterial reconstruction
  • Abdominal Bruit
  • Bilateral leg pain or weakness

    Mesenteric Arterial Duplex
  • Abdominal pain and cramping associated with eating
  • Diarrhea
  • Significant unexplained weight loss
  • Abdominal Bruits
  • Unexplained GI symptoms
  • Post op evaluation


    Venous Duplex Scan Upper and Lower Extremities
    Duplex scanning has almost replaced venography as the diagnostic modality of choice in venous disease. It is cost-effective, pain free, non-invasive and very accurate in diagnosing DVT. Another area in which venous duplex is used is for venous mapping prior to surgery.

    Indications:
  • Pain
  • Swelling
  • Suspected PE
  • Tenderness in extremity
  • Chronic leg ulceration or stasis color changes
  • Varicose Veins
  • Vein Mapping


    PERIPHERAL VASCULAR LABORATORY
  • Carotid Duplex
  • Venous Duplex
  • Segmental Doppler Studies
  • Renal Duplex
  • Abdominal Duplex
  • Peripheral Arterial Duplex
  • Photoplethsmography (PPG)
  • Allen's Test of Palmar Arch


    OUR TECHNICAL STAFF:
    April Christopher, RVT
    Technical Director

    April Sims
    Vascular Sonographer

    OUR REPORTS:
  • Same day preliminary reports will be faxed to the referring physicians office
  • If the patients study yields a significant finding, the patient will remain in the office until verbal communication to referring physician is obtained
  • Transcribed reports will be provided via fax within 48 hours of test. Results will also be mailed to physician's office.