Vascular Lab Services

Physiological multi-level with exercise:

A study performed using blood pressure cuffs to evaluate suspected arterial disease in ambulatory patients. The Physiological Study is not ideal for patients with obesity, ulcers, wound dressings, casts, intolerance to cuff pressure, stents, venous thrombosis, vascular surgery, or limited mobility. Exercise studies are not preformed if significant cardio-pulmonary disease is suspected.

Duplex with Ankle Brachial Index, ABI:

A study performed using duplex ultrasound to evaluate suspected arterial disease. Duplex studies can be limited by obesity, open wounds, non-compliance, casts, and wound dressings. Access to the skin is necessary.

Transcutaneous Oxygen, TCPO2

  • Wound Healing Potential (TCPO2)

Common Arterial Study Indications

  • Limb Claudication
  • Ischemic Ulceration
  • Gangrene
  • Rest Pain
  • Known Arterial Disease
  • Evidence of Thrombo-Embolic Events
  • Vascular Trauma
  • Follow Up of Bypass Grafts, Stent Placement, or Post Angioplasty Status(Duplex)

Carotid Studies

The extracranial cerebral arterial duplex study provides data about blood flow, vessel stenosis, and plaque composition. The carotid and vertebral arteries are evaluated. Evaluation of the extra-cranial cerebral circulation requires patient cooperation. Patients must be able to cooperate and remain quiet during exam performance.

Common Carotid Study Indications

  • Carotid Bruit
  • Transient Cerebral Ischemia
  • Stroke
  • Amaurosis Fugax
  • Known Carotid Disease
  • Post Interventional Follow up
  • Pulsatile Neck Mass
  • Vascular Trauma

An appropriate clinical indication, such as those listed above, is needed for exam performance. Syncope is rarely caused by unilateral carotid disease.

Trans Doppler Imaging, TCDI

TCDI is available when indicated by the neuro-vascular history and physical exam.

Extremity Venous Studies

Venous Insufficiency Study

The VI study demonstrates deep and superficial thrombosis, vein valve function, collateral and accessory veins, perforating veins, vein size and depth, and venous reflux time.

Common Study Indications

  • Varicose Veins
  • Lower Extremity Edema, Pain
  • Venous Ulceration, Cellultis
  • Skin Pigmentation, Induration

Deep Vein Thrombosis, DVT Study

  • Common Study Indications
  • Extremity Pain, Swelling, Edema
  • Documented Pulmonary Embolism
  • Palpable Cord

The use of pre-performance WELLS screening criteria is useful for documentation and selection of patients for DVT studies.

Acute DVT can not be accurately separated from chronic DVT in many instances. Clinical information is important for accurate diagnosis.

Obesity, edema, open wounds, casts, dressings, patient noncompliance, and patient motion can limit test performance.

A bilateral study is useful if pulmonary thrombo-embolic disease is suspected.

Abdominal Arterial Studies

1. Renal Arteries
2. Aorta and Iliac Arteries
3. Mesenteric Arteries
4. Organ transplant

Common Study Indications

  • Aortic or Iliac Aneurysm
  • Uncontrolled Hypertension with Suspected Renal Artery Disease
  • Abdominal Bruit
  • Mesenteric Ischemia
  • Bypass Graft Surveillance
  • Stent Surveillance

Patient cooperation, bowel gas from eating or drinking, and obesity are limiting issues for abdominal duplex imaging. Clinical information is essential for adequate site focused examination.

The presence of bruit, history of prior surgery, and clinical complaints allow for a site directed exam..

Abdominal Venous Studies

Inferior Vena Cava, IliacVeins, Mesenteric/Portal Vein Studies

Common Study Indications

  • Limb Pain
  • Limb Swelling
  • Dyspnea
  • Known Pulmonary Embolus
  • Known Portal Hypertension

Patient cooperation, bowel gas from eating drinking, or obesity are limiting issues for abdominal duplex imaging. Clinical information is essential for adequate site focused examination.


Vascular Screening Studies

  • PAD, Peripheral Artery Disease
  • AAA, Abdominal Aortic Aneurysm
  • CIMT, Carotid Intimal Medial Thickness

PAD Screening

Poor circulation in the legs, Peripheral Artery Disease, PAD, over 8 million people have it!

PAD causes pain, fatigue, tightness, or aching in the legs.
PAD causes ulceration, gangrene, and amputation
PAD puts you at a 6 times greater risk for heart attack or stroke

You should be tested for PAD if:

You are over 70
You have had a heart attack or stroke
You are over 50 and

  • Have high blood pressure
  • Have high cholesterol
  • Have diabetes
  • Smoke or used to smoke
  • Have a family history of heart attack or strok

Aneurysm (AAA) Screening

Qualified seniors are eligible for a one-time AAA ultrasound screening as part of their Welcome to Medicare physical.*

Should I be worried?

AAA can be safely treated or cured with early diagnosis. Nearly 200,000 people in the United States are diagnosed with AAA annually; approximately 15,000 of these cases may be severe enough to cause death if not treated. This Medicare screening benefit is expected to save thousands of lives.

Are there symptoms?

Most people feel no symptoms, and an AAA is often detected when tests are conducted for other unrelated reasons.
Those with symptoms describe them as:

  • A pulsing feeling in their abdomen
  • Unexplained, severe pain in their abdomen or lower back
  • Pain, discoloration, or sores on their feet (this is a rare symptom)

Risk Factors

  • Male
  • Aging
  • Atherosclerosis
  • COPD
  • Infection/Inflammation
  • Trauma
  • Genetics, family history

Carotid/Stroke Screening

Strokes result either from obstruction of blood flow to the brain by the plaque or when bits of plaque and clots break off from the plaque and flow to the brain. If left untreated, carotid artery disease may lead to stroke. Depending on its severity, a stroke can be fatal. In Fact, strokes are the third leading cause of death in the United States and the leading cause of permanent disability in older adults.

Causes and Risk Factors

  • Age
  • Hypertension (high blood pressure)
  • Diabetes
  • Smoking
  • High Cholesterol
  • Obesity
  • Lack of Exercise
  • Family History of atherosclerosis (hardening of the arteries) and/or stroke
  • Irregular Heartbeat, particularly atrial fibrillation(a diagnosed condition where the heart chambers quiver and beat ineffectively)

Symptoms

There may be no symptoms in the early stages of carotid artery disease, and stroke could be the first sign of the condition. Stroke, however, typically has warning signs, referred to as mini strokes or transient ischemic attacks. Mini-stroke symptoms are usually temporary, lasting a few minutes to a few hours, and should be treated as serious medical emergencies requiring immediate treatment because they are strong predictors of future stroke.

Some Symptoms of Stroke Include

  • Weakness, numbness, or tingling on one side of the body
  • Inability to control movement of a body part
  • Loss of vision or blurred vision in one or both eyes
  • Inability to speak clearly
  • Difficulty talking or comprehending what others are saying
  • Dizziness or confusion

Diagnosis

The diagnosis of carotid artery disease can be confirmed, and its severity established, by a non invasive Duplex ultrasound examination. If you experience symptoms of a mini-stroke, see a vascular surgeon. They are the only physicians treating vascular disease today who can perform all the treatment options available, including medical management, minimally invasive endovascular angioplasty and stent procedures, and carotid endarterectomy

Additional Studies by Request

  • Dialysis Access
  • Vein Mapping
  • Impotence

 

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