Vascular Imaging with non-invasive Ultrasound
This is a type of non-invasive superficial scan of the body or limbs to look at underlying vascular structures. It uses soundwaves and is completely safe, even for babies as there is no ionizing radiation like X-rays. There are multiple types of ultrasound scans, which can be performed comfortably.
Duplex Ultrasound Also called: Doppler Test, Vascular Lab Test, Duplex Exam, Duplex Scan, Ultrasound, Ultrasound Exam. Duplex ultrasound is a non-invasive evaluation of blood flow through your arteries and veins. This test provides information to help your vascular surgeon make a sound diagnosis and outline a treatment plan. Accuracy is critical, so ultrasound testing is best performed by a credentialed sonographer in an accredited vascular laboratory.
Carotid Duplex Also called: carotid Doppler, carotid ultrasound, Doppler ultrasound.
This painless, non-invasive test is used to see and measure the rate at which blood flows through your carotid arteries and look for possible blockages. No radiation, dye or needles are used. The test may be performed in a vascular laboratory, a doctor’s office or a radiology department.
Ankle-Brachial Index or ABI Test Also called: Segmental Pressure Test, Toe Pressure Test, Toe-Brachial Index (TBI) A non-invasive test that uses inflatable cuffs to gauge circulation (blood flow) and measure blood pressure in the arteries at various locations on the thigh, calf, foot and toes. Done in an outpatient clinic or vascular laboratory. Minimal, brief discomfort, similar to what you feel while having a routine blood pressure test with an inflatable arm cuff.
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. CVI causes blood to “pool” or collect in these veins, and this pooling is called stasis. Veins return blood to the heart from all the body’s organs. To reach the heart, the blood needs to flow upward from the veins in the legs. Calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing up, and not back down, the veins contain one-way valves.
Chronic venous insufficiency occurs when these valves become damaged, allowing the blood to leak backward. Valve damage may occur as the result of aging, extended sitting or standing or a combination of aging and reduced mobility. When the veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the veins stays elevated for long periods of time, leading to CVI.
CVI most commonly occurs as the result of a blood clot in the deep veins of the legs, a disease known as deep vein thrombosis (DVT). CVI also results from pelvic tumors and vascular malformations, and sometimes occurs for unknown reasons. Failure of the valves in leg veins to hold blood against gravity leads to sluggish movement of blood out of the veins, resulting in swollen legs. Chronic venous insufficiency that develops as a result of DVT is also known as post-thrombotic syndrome (PTS). As many as 30 percent of people with DVT will develop this problem within 10 years after diagnosis.
Varicose veins and spider veins Varicose veins and spider veins often occur in the middle-aged and can be uncomfortable and unsightly. They are the result of a condition call chronic venous insufficiency (CVI). For more information, see section on Chronic Venous Insufficiency.
Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm (AAA) is an enlargement or “bulge” that develops in a weakened area within the largest artery in the abdomen. The pressure generated by each heartbeat pushes against the weakened aortic wall, causing the aneurysm to enlarge. If the AAA remains undetected, the aortic wall continues to weaken and the aneurysm continues to grow. Eventually, the aneurysm becomes so large, and its wall so weak, that rupture occurs. When this happens there is massive internal bleeding, a situation that is usually fatal. The only way to break this cycle is to find the AAA before it ruptures and to treat it surgically.
Carotid Artery Disease – Stroke
Carotid artery disease occurs when the main blood vessels to the brain develop a buildup of plaque caused by atherosclerosis, or hardening of the arteries. When the buildup becomes very severe, it can cause a stroke. A stroke occurs when part of the brain is damaged by these vascular problems; in fact, 80 percent of strokes are “ischemic strokes” where part of the circulation to the brain is cut off, usually due to blockages in the carotid arteries. The process is similar to the buildup of plaque in arteries in the heart that causes heart attacks. Strokes are the third leading cause of death in the United States according to the National Center for Health Statistics.
Peripheral Arterial Disease
Peripheral arterial disease (PAD) occurs when atherosclerosis, or hardening of the arteries, causes a buildup of plaque in the blood vessels that carry oxygen and nutrients to all the tissues of the body. As these plaques worsen, they reduce essential blood flow to the limbs and can even cause complete blockages of the arteries. Early PAD may only cause difficulty walking, but in its most severe forms, it can cause painful foot ulcers, infections, and even gangrene, which can result in major limb amputation. People with PAD are three times more likely to die of heart attacks or strokes than those without PAD.
Your vascular system is made up of blood vessels that carry your blood throughout your body. Arteries carry oxygen-rich blood away from your heart. Veins carry oxygen-poor blood back to your heart. Your blood leaves the left side of the heart and is pumped out to the rest of your body.
The main artery from your heart is called the aorta. As your blood travels around your body, it enters smaller and smaller blood vessels, reaching every cell, dropping off nutrients and picking up waste products and carbon dioxide.
Your blood then starts the trip back in your veins, entering larger and larger ones as it goes, passing through your kidneys and liver on the way to drop off waste products. The blood eventually arrives back at the right side of your heart to start the trip all over again. As we age, our arteries tend to thicken, get stiffer and then narrow. This is called arteriosclerosis. A form of arteriosclerosis is atherosclerosis, which is the build-up of plaque and cholesterol in large and medium-sized arteries. Narrowing of the arteries from the build-up of plaque can lead to coronary heart disease, and can cause a heart attack when this occurs in the blood vessels leading to the heart.
The same situation in the arteries leading to the brain can cause strokes. Narrowing of the arteries in other places, such as your legs, can cause what is called Peripheral Arterial Disease, or PAD. PAD can lead to sores, pain with walking or, in the worst case, amputation. When the smaller arteries are affected, it is called arteriosclerosis.
Veins, which are our other type of blood vessel, can also be afflicted by diseases such as venous valve incompetence (reflux) or clotting (thrombosis) in the deep or superficial veins. In the former, venous reflux can give rise to varicose veins, with pain and swelling especially in the legs. Deep vein thrombosis (clots) can be life threatening if they travel to the lung circulation (pulmonary embolus) and require quick and accurate diagnosis, and expedient medical treatment.
Vascular conditions affect the veins and arteries in your body, which conduct oxygen to every living cell. Think of your veins and arteries as expressways or rivers. When there are traffic jams or road construction, or when dams break, trouble ensues. But in most cases, vascular conditions are highly treatable, often without surgery.
It is important to see a vascular surgeon, even when surgery is not needed. Vascular surgeons specialize in treatments of every kind of vascular problem except those of the heart (which are treated by cardiovascular/cardiothoracic surgeons) and the brain (which are treated by neurosurgeons). A common condition such as atherosclerosis may show up in the legs, for example, but affects the whole body. Vascular surgeons will talk to you about how exercise, diet and medication can be the first step in regaining your health. When surgery is needed, vascular surgeons are trained in all types of interventions, not just one or two.
Common vascular conditions are listed below. The information contained within is not intended, and should not be relied upon, as a substitute for medical advice or treatment. It is very important that individuals with specific medical problems or questions consult with their doctor or other healthcare professionals.
- Abdominal Aortic Aneurysm
- Aortic Dissection
- Aortoiliac Occlusive Disease
- Arm Artery Disease
- Carotid Artery Disease
- Chronic Venous Insufficiency
- Connective Tissue Disorder (CTD)
- Deep Vein Thrombosis
- Endoleaks (Type I-V)
- Fibromuscular Disease
- Giant Cell Arteritis
- Mesenteric Ischemia
- Peripheral Aneurysm
- Peripheral Arterial Disease
- Portal Hypertension
- Pulmonary Embolism
- Renovascular Conditions
- Thoracic Aortic Aneurysm
- Thoracic Outlet Syndrome
- Varicose Veins
- Vascular Infections
- Vascular Trauma
- Visceral Artery Aneurysm