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Vascular Diagnostic Tests

To provide the best possible treatment of a vascular condition or disease, we utilize the following vascular diagnostic tests to analyze each patient's health. All Tanner Health System ultrasound technologists are registered by the American Registry of Diagnostic Medical Sonography; they provide expert interpretations of test results so that an accurate diagnosis can be made.

Ankle Brachial Index Test

The ankle-brachial index (ABI) is a test used to diagnose and predict the severity of peripheral artery disease (PAD). A resting ABI of 0.41 to 0.9 indicates mild to moderate PAD; a resting ABI of 0.4 or lower indicates severe PAD. A normal resting ABI is between 0.9 and 1.3, which means that your blood pressure at your ankle is the same as or greater than the pressure in your arm.

How is it performed?

This test is done by measuring blood pressure at the ankle and in the arm while a person is at rest. Measurements are usually repeated at both sites after five minutes of walking on a treadmill.

Peripheral Vascular Ultrasound

Your vascular system — your body’s system of veins and arteries — can have blockages that constrict blood flow to certain parts of the body. These blood vessels supply blood to your arms and legs. They can be evaluated with ultrasound. A peripheral ultrasound looks at the body’s blood vessels for inflammation, blood clots or blockages. The ultrasound technologist will see a color doppler (image) of the arteries and veins, and be able to hear the blood flow.

How is it performed?
The test uses ultrasound imaging to evaluate the blood flow and possible blockage or clots in the arteries or veins of your legs or arms. You will be asked to lie on your back and a gel will be applied to the area being examined. A Tanner technologist will move a device called a transducer over the area to get a picture of blood flow in your arteries or veins. The transducer sends out ultrasound waves to the arteries or veins, which are then bounced-back and collected by the transducer to provide an image.

How do I prepare?
No preparation is necessary.

Abdominal Vascular ULS

Vascular ultrasound uses sound waves to create images of the insides of the arteries in your deep abdominal organs, such as renal arteries, mesenteric arteries, and the hepatic and portal systems of the liver.

How is it performed?
The test uses ultrasound imaging to evaluate the blood flow and possible blockage or clots in the arteries of your kidneys. You will be asked to lie on your side and a gel will be applied to the area being examined. Your technologist will move the transducer over the area to get a picture of blood flow in your renal arteries and aorta.

How do I prepare?
Do not eat or drink anything for eight hours before the test.

Carotid Ultrasound

Carotid ultrasound uses sound waves to create images of the insides of the two large arteries in your neck. These arteries, called carotid arteries, supply your brain with blood. You have one carotid artery on each side of your neck.

Carotid ultrasound shows whether a material called plaque has narrowed your carotid arteries. Plaque is made up of fat, cholesterol, calcium and other substances found in the blood. It collects on the insides of your arteries as you age. A blockage in these arteries can lead to a stroke.

How is it performed?
The test uses ultrasound imaging to evaluate the blood flow and possible blockage or clots in the arteries of your neck. You will be asked to lie on your back and a gel will be applied to the area being examined. Your technologist will move the transducer over the area to get a picture of blood flow in your arteries.

How do I prepare?
No preparation is necessary.

Peripheral Angioplasty and/or Stenting

Peripheral artery disease (PAD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels — the arteries, veins or lymphatic vessels. Organs supplied by these vessels — such as the brain, heart, kidneys and legs — may not receive adequate blood flow for ordinary function. However, the legs and feet are most commonly affected, thus the name peripheral artery disease.

The terms “peripheral artery disease,” “peripheral vascular disease” and “peripheral arterial disease” are often used interchangeably. In the United States, about 10 million people have peripheral artery disease. It is frequently found in people with coronary artery disease, because atherosclerosis, which causes coronary artery disease, is a widespread disease of the arteries.

There are two main goals for treatment of PAD: control the symptoms and halt the progression of the disease to lower the risk of heart attack, stroke, and other complications.

A common treatment for PAD is peripheral arterial angioplasty and stenting. With angioplasty, a long, hollow tube called a catheter is used to create a larger opening in an artery to increase blood flow. Angioplasty may be performed in many of the arteries in the body, including the coronary arteries that supply blood to the heart.

There are several types of angioplasty procedures, including:

  • Balloon angioplasty – a small balloon is inflated inside the blocked artery to open the blocked area
  • Atherectomy – the blocked area inside the artery is “shaved” away by a tiny device on the end of a catheter
  • Laser angioplasty – a laser is used to “vaporize” the blockage in the artery
  • Stenting – a tiny coil, called a stent, is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open

How do I prepare?
Do not eat or drink after midnight. Medications prescribed by your doctor may be taken with sips of water unless otherwise directed. If the procedure is scheduled for the afternoon, you may be allowed to have an early liquid breakfast (juice, tea, broth, water, etc.) prior to 7 a.m. Many patients are able to return home the same day as the procedure, but you should arrange to have someone available to drive you home.

Aftercare
The catheter will be removed and the incision will be bandaged with a sterile dressing.

If the catheter was inserted in your arm, you will need to keep your arm straight for at least an hour. Tanner Heart and Vascular Center staff will continue to monitor you for a few hours to ensure that you do not experience any adverse side effects following the procedure.

If the catheter was inserted in your leg, the incision will be closed with applied pressure and a suture device. Tanner Heart and Vascular Center staff will ask you to lie flat and keep your leg straight for two to six hours. This helps to prevent bleeding. Your head may not be raised higher than 30 degrees (about two pillows in height), and you will be asked to avoid trying to sit or stand.

After you are discharged, you will need to drink lots of liquids to help remove the contrast material from your system. It is normal to feel the need to urinate more frequently. If you have been placed on bed rest, you should use a bedpan or bedside urinal.

Further instructions, including care of the catheterization site and incision, as well as diet changes and medication adjustments, will be discussed by a member of your patient care team when you are discharged.

Atherectomy

An atherectomy is a procedure during which a specialized catheter is inserted into a blocked artery to remove a buildup of atherosclerotic plaque from within the vessel. The catheter contains a sharp rotating blade that lets your doctor remove the plaque from the wall of the vessel and collect or suction any resulting debris.

Atherectomy is typically used to treat blockages in peripheral arteries such as the legs. Atherectomy can be used as a stand-alone treatment for blockages or in conjunction with angioplasty and stenting.

How is it performed?
You will be given a local anesthetic to numb the area where the catheter will be inserted. You will stay awake during the procedure, but will be sedated for comfort.

Your doctor will thread a thin guidewire into the blocked artery through a needle inserted in your groin. Dye is injected into the artery and X-ray images are taken while the dye moves through your artery. Using these X-ray images, your doctor will move an atherectomy catheter to the location of the blockage. The catheter contains a cutting blade that will be used to remove the blockage. The catheter is then removed.

How do I prepare?
Do not eat or drink after midnight. Medicines prescribed by your doctor may be taken with sips of water. If the procedure is scheduled for the afternoon, you may be allowed to have an early liquid breakfast (juice, tea, broth, water, etc.) prior to 7 a.m. You will need to stay in the hospital overnight.

CryoPlasty

CryoPlasty, or cryo-balloon angioplasty, is very similar to traditional balloon angioplasty used to restore the flow of blood to heart vessels.

How is it performed?
CryoPlasty is similar to angioplasty and uses cardiac cath technology to help your doctor see where and what type of treatment is needed. As with a cath, you will receive medicine to help you relax (sedative) through an intravenous (“IV”) line. You will be given a local anesthetic to numb the area where the catheter will be inserted.

Your doctor will thread a thin tube, called a catheter, to the site of a blockage in either your arms or legs. A tiny balloon at the end of the catheter is filled with liquid nitrous oxide, which evaporates in the balloon, becoming a gas and causing the balloon to dilate and cool to 14 degrees Fahrenheit.

How do I prepare?
Do not eat or drink after midnight. Medicines prescribed by your doctor may be taken with sips of water. If the procedure is scheduled for the afternoon, you may be allowed to have an early liquid breakfast (juice, tea, broth, water, etc.) prior to 7 a.m. You will need to stay in the hospital overnight.

Learn more about Tanner Vascular Surgery now or call 770.812.5902 to make an appointment.

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