Peripheral Vascular Disease (cont.)
How is peripheral artery disease diagnosed?
During a physical examination, your doctor may look for signs that are
indicative of peripheral artery disease, including weak or absent artery pulses in the extremities,
specific sounds (called bruits) that can be heard over the arteries with a
stethoscope, changes in blood pressure in the
limbs at rest and/or during exercise (treadmill test), and skin color and nail
changes due to tissue ischemia.
In addition to the history of symptoms and the physical
signs of peripheral artery disease described above, doctors can use imaging tests in the diagnosis of
peripheral artery disease. These imaging tests
include:
- Doppler ultrasound - A form of
ultrasound (measurement of high-frequency sound waves that are
reflected off of tissues) that can detect and measure blood flow. Doppler
ultrasound is used to measure blood pressures behind the knees and at the
ankles. In patients with significant peripheral artery disease in the legs, the blood pressures in the
ankles will be lower than the blood pressure in the arms (brachial blood
pressure). The ankle-brachial index (ABI) is a number derived from dividing the
ankle blood pressure by the brachial blood pressure. ABI of .9 to 1.3 is normal,
ABI less than 0.9 indicate the presence of peripheral artery disease in the arteries in the legs, and
ABI below 0.5 usually indicates severe arterial occlusion in the legs.
- Duplex ultrasound - is a color
assisted non-invasive technique to study the arteries. Ultrasound probes can be
placed on the skin overlying the arteries and can accurately detect the site of
artery stenosis as well as measure the degree
of obstruction.
- Angiography - An angiography is an imaging procedure to study the blood vessels similar to coronary
angiogram. It is the most accurate test to detect the location(s) and severity
of artery occlusion, as well as collateral circulations. Small hollow plastic
tubes (catheters) are advanced from a small skin puncture at the groin (or the
arm), under x-ray guidance, to the aorta and the arteries. Iodine contrast
"dye," is then injected into the arteries while an x-ray video is recorded.
Angiogram gives the doctor a picture of the location and severity of narrowed
artery segments. This information is important in helping the doctor select
patients for angioplasty or surgical bypass (see below).
Because x-ray
angiography is invasive with potential side effects (such
as injury to blood vessels and contrast dye reactions), it is not used for
initial diagnosis of peripheral artery disease. It is only used when a patient with severe
peripheral artery disease
symptoms is considered for angioplasty or surgery. A number of different imaging methods have been used in angiography examinations, including x-rays, magnetic resonance imaging (MRI), and computed tomography
(CT) scans.
- Magnetic resonance imaging (MRI) angiography
uses magnetism, radio waves, and a computer to produce images of body structures and has the advantage of avoiding x-ray radiation exposure.
Next: What are the treatments for peripheral artery
disease? »
- warfarin, Coumadin - Reveals the medication warfarin (Coumadin) a drug used to inhibit the synthesis of clotting factors, thus preventing blood clot formation. Article includes descriptions, uses, drug interactions, and side effects.
- Ultrasound - Learn an ultrasound procedure, and conditions and diseases it assists in diagnosing and screening like tumors, cysts, heart conditions and more.
- Kidney Failure - Learn about kidney failure, in which the body has fluid retention, risen blood pressure, toxin build up and lack of red blood cells. Symptoms include fatigue, nausea, and apetite loss.
Latest Medical News
Heart RSS