THE LORD for this. Although it is very debilitating. As time goes on it is harder and harder to walk.
I am 54 years young and truly thought that this would happen in my mid sixties. :D Alas it was not to be.
I can honestly say I love all of my Drs and appreciate them so very much. I love their staff, they are really good to me. If you have to have dopplers, do research, ask questions :D I ask alot of questions to the person who is doing them. Thankfully they are kind and answer them for me. The Lord has blessed me with a good attitude and even when someone is not very kind to me, I pretend I dont notice and smile and continue. :D I hope that this information helps you out. if you have any questions feel free to ask. I do not know all the answers, I am not afraid to ask those who know better than I do.
I will do my best to answer them for you. I am not afraid to say...................
................. I DONT KNOW BUT WILL FIND THE ANSWER...............
God is amazing. he will see me through this , I am stronger because of him.
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Carotid Duplex
A carotid duplex is a noninvasive ultrasound test which allows physicians to evaluate carotid arteries, the arteries that carry blood to the brain. Duplex ultrasound demonstrates how well blood is flowing through these vessels, the speed with which the blood is flowing, and measures the diameter of the vessel walls to evaluate for any plaque buildup or obstruction that may be present.
 | This test is performed in an outpatient setting by an ultrasound technologist, and there is no specific preparation involved. During the test, you will be positioned lying on a table. The ultrasound technologist will spread ultrasound gel over the area that they will examine, and then place the ultrasound probe against your skin. This may cause some mild discomfort, however most patients do not report any pain. They will then proceed to take pictures in multiple angles in order to record all of the data that they will need. |
The test typically takes about 30 minutes and after the test is complete, you may immediately resume your normal activities. The results will be interpreted by an Interventional Radiologist, and your referring physician will be made aware of those results.
Peripheral Vascular Ultrasounds
A peripheral ultrasound is a noninvasive test which allows physicians to evaluate the veins that carry blood throughout your body. Duplex ultrasound demonstrates how well blood is flowing through these vessels, the speed with which the blood is flowing, and measures the diameter of the vessel walls to evaluate for any obstruction, blood clot, or damage to the valves that may be present.
This test is performed in an outpatient setting by an ultrasound technologist, and there is no specific preparation involved. During the test, you will be positioned lying on a table, or standing. The ultrasound technologist will spread ultrasound gel over the area that they will examine, and then place the ultrasound probe against your skin. This may cause some mild discomfort, however most patients do not report any pain. They will then proceed to take pictures in multiple angles in order to record all of the data that they will need.
The test typically takes about 30 minutes and after the test is complete, you may immediately resume your normal activities. The results will be interpreted by an Interventional Radiologist, and your referring physician will be made aware of those results.
Ankle Brachial Index (ABI)
An Ankle Brachial Index (ABI) is a test that measures the blood pressure in the arms, calves, and big toes. After these measurements are taken, the ratio of the blood pressure in the lower legs to the blood pressure in the arms is calculated. This test is done in order to predict the severity of peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD). The test may also be used to see how well a treatment is working if your doctor has placed you on medical treatment, an exercise program, or you have already undergone angioplasty or surgery.
This test is performed in an outpatient setting by a technologist. The technologist will place multiple different blood pressure cuffs on your arms, and lower calves, as well as the big toes. The pressures will then be measured. Most patients report only minor discomfort from the pressure of the cuff during inflation. Once the test is completed, an interventional radiologist will interpret the results, and discuss them with your referring physician to determine if any further treatment is necessary.
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Ankle-Brachial Index (ABI) Test
What is an Ankle-Brachial Index (ABI)?
An ABI test is a simple, reliable test for diagnosing PAD in the legs. The test measures the blood pressure in your ankles and compares it to that in your arms. If the blood pressure is lower in your legs than in your arms, it may indicate that PAD is restricting blood flow in your legs. The ABI test is fast and painless, and does not require entering the body.
In some cases, the ABI test may be performed after exercise on a treadmill, called an exercise ABI. The exercise ABI can diagnose PAD in women who have PAD symptoms during exercise, but a normal ABI measurement at rest. In the early stages, PAD may only cause symptoms when the leg muscles are working hard and need more blood than usual. See Exercise Tests for more detailed information.
Who might have an ABI test?
Because it is simple, reliable, and safe, the ABI test is usually the first test used to diagnose PAD in women who have PAD symptoms such as leg discomfort, numbness, or nonhealing sores.
The ABI is also used to look for PAD in women who do not have any symptoms, but are at risk for the disease because they have risk factors for PAD. See PAD Screening to find out if you should be tested for PAD, and to find a screening site near you.
In women who have already been diagnosed with PAD, the ABI can monitor how severe your PAD is and help predict whether wounds will heal on their own. After a procedure to open leg arteries such as angioplasty, stenting, or lower-extremitybypass surgery, an ABI can indicate how effective the treatment was at improving blood flow in the leg.
Who should not have an ABI test?
Women who have a suspected blood clot in the veins of the legs (deep vein thrombosis, or DVT) should not have an ABI test. Because the ABI involves squeezing the leg with a blood pressure cuff to stop blood flow, it could cause a clot in the leg veins to break off and travel to the lungs, causing a potentially deadlypulmonary embolism. For this reason, an ultrasound should be used to rule out DVT before performing an ABI in women with suspected blood clots in the veins.
How do I prepare for the test?
You should not smoke or participate in strenuous activities for 24 hours before the test. You should take any medications and eat and drink as you normally would.
What happens during an ABI test?
The ABI test is simple and painless, and takes about 15 minutes. It can be performed in your doctor's office or at specialized testing center.
You will lie on your back on a table. A technologist will place a blood pressure cuff on your upper arm, and it will be inflated until blood flow through the brachial artery(which runs down the inside of your upper arm) stops. As the cuff is slowly deflated, the doctor will measure your systolic blood pressure (the top number in a normalblood pressure measurement) using a hand-held device called a Doppler probe placed near the crease of your elbow. The probe is a pen-like device that is pressed lightly against your skin and uses reflected sound waves to accurately measure blood pressure. The technologist will apply a bit of gel to your skin before using the probe to help the sound waves travel better. This process will be repeated with the other arm.
Then the technologist will measure your blood pressure in each leg. The doctor will feel for the pulse in the artery that runs down your leg over the top part of your foot. A blood pressure cuff just above your ankle will be inflated and slowly deflated, and the Doppler probe will be used to measure blood pressure. This will be repeated for the artery on the inside of your ankle.
The ankle-brachial index (ABI) test.
What do the results mean?
Your ABI number is calculated by taking the systolic (top number) blood pressure in your ankle and dividing by the blood pressure in your arm. When the blood pressure readings are different between your left and right arm, the higher of the two numbers is used.
A low ABI means the blood pressure in your legs is lower than that in your arms, indicating that PAD is restricting blood flow to your legs. The lower your ABI number, the more severe your PAD is. Women with a lower ABI are more likely you are to suffer complications of PAD such as foot ulcers and walking limitations.1,2
A low ABI score also indicates you are at risk for other forms of artery disease, including coronary artery disease. In one large study, women with an ABI of 0.90 or less were 3.5 times as likely to die of heart disease within 10 years compared with women with a normal ABI.3
| Ankle-Brachial Index (ABI) Results4 | ||
| ABI Number | Diagnosis | What It Means |
| 1.00 to 1.29 | Normal | Your ABI is in the normal range and you are not likely to have PAD. |
| 0.91-0.99 | Borderline | Your ABI is slightly lower than normal, but not low enough to diagnose PAD. Your doctor may want to measure your ABI again soon to make sure it is not getting worse, or measure your ABI after exercise. |
| 0.41 to 0.90 | Mild-to-moderate PAD | You have PAD. Working with your doctor to get your risk factors under control can prevent the disease from getting worse, and treatments are available to help relieve your PAD symptoms. |
| 0.40 or less | Severe PAD | The blood flow in your legs is severely obstructed, and you may need immediate treatment to relieve your symptoms and prevent serious complications. |
An ABI higher than 1.3 indicates that the arteries in your legs are stiff and cannot be closed off by the blood pressure cuff, causing an inaccurate reading. This often happens in elderly women and women who have had diabetes for many years or who are on dialysis for chronic kidney disease.
If your arteries are too stiff to get an accurate ABI reading, you will need another test to diagnose PAD, such as a toe-brachial index (TBI), pulse volume recording, or ultrasound.
How reliable is the ABI test at detecting PAD?
The ABI is one of the most accurate tests for diagnosing PAD in the legs. Studies have shown that the ABI can identify about 90% of women with PAD, and fewer than 5% of women with a low ABI turn out not to have PAD.5,6
Women tend to have slightly lower ABI numbers than men do. One study of 1,775 healthy people (58% were women) found that, on average, women had ABIs that were 0.02 lower than men's.7 However, there is no evidence that the ABI test is less accurate for diagnosing PAD in women compared with men, or that different ABI cutoffs should be used for women.
What are the risks of an ABI test?
The ABI test is generally safe and painless, and does not require entering the body. You may feel some discomfort as the blood pressure cuff inflates to cut off blood flow.
If you have blood clots in the veins (DVT), the squeezing of the blood pressure cuff during an ABI test could cause the clot to break off and travel through the bloodstream. If the clot becomes lodged in another blood vessel this can cause serious complications, such as a potentially deadly pulmonary embolism. For this reason, an ultrasound should be used to rule out DVT before performing an ABI in women with suspected blood clots in the veins.
What happens next?
If your ABI number indicates you may have PAD, you may need more tests to examine blood flow in your leg arteries if a procedure is planned. If you have only mild-to-moderate PAD, you doctor may decide to start you on a treatment plan and check your ABI again if your symptoms get worse.
If your ABI is lower than normal but not yet low enough to diagnose PAD (a borderline result), your doctor may want to check your ABI after exercise (seeexercise tests for more).
Other tests that may be used to further investigate PAD include:
- Functional tests to provide additional information about blood flow:
- Tests that produce pictures of the shape of the arteries and blood flow through them:
Related Tests
What is a segmental pressure measurement test?
A segmental pressure test is performed in the same way as an ABI test, except that additional blood pressure cuffs are used to take measurements in different parts of the leg. Usually the test uses four cuffs, placed on the upper thigh, lower thigh, upper calf, and just above the ankle, with blood pressure measurements taken at each point.
Segmental blood pressure measurement.
The segmental blood pressure test is used to get a better idea of where a blockage or narrowing your leg arteries is located. If the blood pressure drops more than about 20 mm Hg between one cuff and the next, it is likely that the blockage is located in between those two cuffs.4
Like an ABI, segmental pressure measurement may be used to diagnose PAD or determine the effectiveness of PAD treatments. While the ABI can only tell whether or not you have PAD, segmental blood pressure measurement can also show approximately where the blockage is located. This information may be used to predict whether sores on the leg will heal based on their location, or to help formulate a PAD treatment plan. If doctors need to know the exact location or extent of a blocked artery, they may use a more detailed test such as ultrasound, an MR angiogram, a CT angiogram, or a contrast angiogram.
What is a toe-brachial index test?
A toe-brachial index test (TBI) is nearly identical to an ABI test, except instead of measuring the blood pressure in your ankle, a tiny blood pressure cuff and sensor are used to measure the blood pressure in your big toe.
A TBI test is often used to diagnose PAD in women whose leg arteries are too stiff to get an accurate ABI result (an ABI more than 1.3). The TBI is more accurate in these women because the arteries in the toe are usually not as stiff as those in the leg. A TBI of 0.7 or less usually means you have PAD. The TBI is also useful for predicting whether wounds on the foot or toe will heal.
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How to Perform a TBI Toe Brachial Index
A Toe Brachial Index or TBI is performed when the ABI or Ankle Brachial Index is abnormally high due to plaque and calcification of the arteries in the leg; this is caused by atherosclerosis and is most often found in diabetic patients. The abnormally high ABI is >1.3.
Equipment Needed: The TBI Package which includes the MD6RP Photo plethysmograph and photo transducer and digit cuffs (two UPC 2.5) as well as the Portable ABI Kit which provides the MD6VR Chart Recorder, S300 Aneroid Sphygmomanometer, and two SC12 and 2 SC10 Straight Segmental Cuffs.
Preparation of the Patient: The patient should be in a warm comfortable room, supine with arms and legs at heart level. Keep feet warm with a blanket or towel if needed.
The Procedure: Select the appropriate sized cuff for each limb. You will need one cuff for each upper arm and for each large toe. Measure the cuff width to the diameter of the limb; the cuff width should be 20% larger than the limb diameter to compress all of the soft tissue evenly. The cuff should be put on straight and fit snuggly but not tight. You must use vascular cuffs which have long bladders to completely encircle the limb and compress all of the soft tissue. The toe cuff should be wide enough to apply pressure over a large enough area so as to not be a tourniquet and long enough to over lap the bladder.
Put the cuffs on the arms and toes once the patient is supine. Have the sphygmomanometer, patient chart, etc. in the room ready to use. A patient can relax best if undisturbed.
The rest period should be at least 10 minutes with 15-20 ideal. The goal is for the patient to relax. This time can be used for interviewing the patient, listening to the heart, palpating the abdomen, checking the neurological reflexes and sensation in the feet.
After the rest period, take the first brachial pressure. Find the brachial pulse with your fingers, and then put some ultra phonic gel on that place. Obtain a good Doppler signal (sound) and waveform, print out to establish a base line. Inflate the cuff until the sound and waveform disappear and then inflate from 20-30 mmHg above that number (super systolic). Slowly deflate the cuff (around 2-3 mmHg at a time) until the sound reappears (Korotkoff sound) the waveform will follow immediately after the sound. The pressure reading when the first sound appears is the correct systolic pressure. Deflate the cuff completely and record the systolic pressure.
D.E. Hokanson, Inc. 425-882-1689 www.hokanson.ccHow to Perform a TBI Toe Brachial Index
After you have taken the first brachial systolic pressure you can either do the other brachial pressure or the first toe pressure.
Check to see if the cuff is well placed. Put the ppg or photo plethysmograph on the pad of the large toe and not touching the cuffs. Make sure the Velcro will hold the ppg in place but not compress the blood vessels by being too tight. You should see the patient’s pulse as a waveform on the chart recorder. Connect the sphygmomanometer to the toe pressure cuff and inflate slowly until you see the waveform disappear. Note the pressure and continue to inflate until 20-30 mmHg above that pressure (super systolic). Now slowly release the pressure in the cuff at about 2 mmHg per declination until the waveform reappears. This is the systolic pressure. Make a note of it. Deflate the cuff completely. Repeat the toe and brachial pressures on the other side.
How to calculate the TBI
Divide the highest toe pressure by the highest brachial pressure the result is the TBI. 0.65 - 0.7 and above is normal for TBI
Interpretation1 0.64 +/- .20 limbs normal 0.52 =/- .20 claudication in limbs 0.23 =/- .19 limbs with ulcers or ischemic rest pain
A toe systolic pressure greater than 30 mmHg may be an indicator that there is healing potential in a foot with ulcers.
A normal TBI differs from a normal ABI because the normal blood pressure in the big toe (hallux) is expected to be less than at the ankle or the arm. The normal range for a TBI is considered to be an index > 0.65. It the TBI is below 0.65 there is reduced blood flow to the small vessels in the big toe.
1Zierler RE, Sumner DS, “Physiologic Assessment of Peripheral Arterial Occlusive Disease”, Chapter 6 Vascular Surgery 4th Edition 1:85-117 WB Saunders CO., Orlando FL 1995
D.E. Hokanson, Inc. 425-882-1689 www.hokanson.cc
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What you need to know about the ABI examination for peripheral arterial disease (PAD)
Information recreated from the Vascular Disease FoundationBrochure: http://www.vdf.org/pdfs/VDF_FocusOnABI.pdf
Web site: http://www.vdf.org/
Web site: http://www.vdf.org/
What is the ABI?
The ankle-brachial index (ABI) is a simple and reliable means for diagnosing peripheral arterial disease or PAD. Blood pressure measurements are taken at the arms and ankles using a pencil shaped ultrasound device called a Doppler (an instrument that produces sound waves not x-rays) or other specialized measuring instrument. These are considered noninvasive because they do not require the use of needles or catheters. The ABI test is simple enough to be performed in a doctor’s office or vascular laboratory. Not only is the ABI one of the most reliable tests for PAD, it is also the least expensive. The ABI exam can be used to assess whether PAD is getting worse, the severity of an individual’s atherosclerosis (build up of plaque) as well as the risk of leg problems, such as development of leg rest pain, poor healing of foot wounds, the need for bypass surgery, or amputation. It can also predict the risk of future problems from atherosclerosis such as heart attack and stroke.
How is the exam given?
You will be asked to lie on your back while standard blood pressure cuffs are placed around your ankles and arms. These cuffs will be inflated briefly above your normal systolic blood pressure. Once the cuffs are deflated, blood pressure measurements are taken using a Doppler instrument or other specialized measuring instrument. The arm and ankle systolic blood pressure measurements are recorded. Then the ankle systolic pressures are divided by the highest arm pressure to establish an ABI measurement for each leg.
If you have symptoms of PAD you may be asked to walk on a treadmill or down the hallway and the ankle pressure measurements are repeated to see if they have changed.
How reliable is the exam?
Although the ABI is extremely reliable, this test may not be accurate in all patients. Some people with long-standing diabetes, kidney disease or some elderly patients, may have rigid blood vessels. These may be difficult to compress with the blood pressure cuff, and in these patients the ABI reading may not be accurate. For individuals with rigid ankle blood vessels, toe pressure measurements may be taken since toe arteries are rarely rigid. This examination is called a toe brachial index (TBI) and is a calculation based on the systolic blood pressures of the arm and the systolic blood pressures of the toes. The examination is similar to the ABI except that it is performed with a photoplethysmograph (PPG) infrared light sensor and a very small blood pressure cuff placed around the toe. A TBI of .8 or greater is considered normal. Alternatively, a leg arterial ultrasound test or pulse volume recording using pressure cuffs on the thigh can also detect PAD when the ABI cannot performed.
Although the ABI is extremely reliable, this test may not be accurate in all patients. Some people with long-standing diabetes, kidney disease or some elderly patients, may have rigid blood vessels. These may be difficult to compress with the blood pressure cuff, and in these patients the ABI reading may not be accurate. For individuals with rigid ankle blood vessels, toe pressure measurements may be taken since toe arteries are rarely rigid. This examination is called a toe brachial index (TBI) and is a calculation based on the systolic blood pressures of the arm and the systolic blood pressures of the toes. The examination is similar to the ABI except that it is performed with a photoplethysmograph (PPG) infrared light sensor and a very small blood pressure cuff placed around the toe. A TBI of .8 or greater is considered normal. Alternatively, a leg arterial ultrasound test or pulse volume recording using pressure cuffs on the thigh can also detect PAD when the ABI cannot performed.
Interpreting the ABI
The ABI range that is generally considered normal is 1.0-1.3.
> 1.30 Noncompressible
1.0 – 1.29 Normal
0.91 – 0.99 Borderline (equivocal)
0.41 – 0.90 Mild to moderate PAD
0.00 – 0.40 Severe PAD
The ABI range that is generally considered normal is 1.0-1.3.
> 1.30 Noncompressible
1.0 – 1.29 Normal
0.91 – 0.99 Borderline (equivocal)
0.41 – 0.90 Mild to moderate PAD
0.00 – 0.40 Severe PAD
About PAD
Peripheral Arterial Disease or “PAD” is sometimes also known as peripheral vascular disease or “PVD. It is leg atherosclerosis, claudication, or just poor circulation. Arteries can slowly become narrowed or blocked as a consequence of age, smoking, high blood cholesterol or diabetes. Less blood reaching the muscles in the legs can make them hurt. PAD can usually be effectively treated by a healthier lifestyle, daily exercise and medications to decrease leg pains and improve one’s chance of avoiding heart attack or stroke. For individuals with the most severe blockages, skin ulcers, non-healing wounds, or even gangrene can occur. With prompt treatment, pain can be lessened and amputation may be avoided.
Peripheral Arterial Disease or “PAD” is sometimes also known as peripheral vascular disease or “PVD. It is leg atherosclerosis, claudication, or just poor circulation. Arteries can slowly become narrowed or blocked as a consequence of age, smoking, high blood cholesterol or diabetes. Less blood reaching the muscles in the legs can make them hurt. PAD can usually be effectively treated by a healthier lifestyle, daily exercise and medications to decrease leg pains and improve one’s chance of avoiding heart attack or stroke. For individuals with the most severe blockages, skin ulcers, non-healing wounds, or even gangrene can occur. With prompt treatment, pain can be lessened and amputation may be avoided.
For more information about PAD, Walking and PAD and other topics, contact 866.PAD.INFO (866.723.4636) or visit http://www.vdf.org/
Who is at Risk?
Over 9 million Americans are affected by PAD, yet many do not know they have it. You may be at risk for PAD if you:
• Smoke
• Have high cholesterol
• Have high blood pressure
• Are over 50 years old
• Have a family history of heart disease
• Have diabetes
• Have pain in your legs when you walk that goes away with rest
Who is at Risk?
Over 9 million Americans are affected by PAD, yet many do not know they have it. You may be at risk for PAD if you:
• Smoke
• Have high cholesterol
• Have high blood pressure
• Are over 50 years old
• Have a family history of heart disease
• Have diabetes
• Have pain in your legs when you walk that goes away with rest
What are the symptoms?
About one half of individuals with PAD do not have symptoms. The most common symptom is a burning pain or ache which occurs in one or both legs and quickly goes away when you rest. It occurs every time you walk about the same distance. This is known as intermittent claudication. This leg pain can be severe enough to deter a person from normal walking. Some individuals will not feel cramping or pain but might feel a numbness, weakness or heaviness in the muscles.
About one half of individuals with PAD do not have symptoms. The most common symptom is a burning pain or ache which occurs in one or both legs and quickly goes away when you rest. It occurs every time you walk about the same distance. This is known as intermittent claudication. This leg pain can be severe enough to deter a person from normal walking. Some individuals will not feel cramping or pain but might feel a numbness, weakness or heaviness in the muscles.
What are the treatments?
While there is no cure for PAD, there are many ways to prevent the progression of the disease. Good health practices such as eating a healthy diet, exercise and not smoking will slow the progress of the disease. Walking has been shown to reduce symptoms of PAD. Treatment options vary and depend on the overall health of the individual and the severity of the disease. If you have PAD, your physician should provide you with adequate information to help you understand all options.
While there is no cure for PAD, there are many ways to prevent the progression of the disease. Good health practices such as eating a healthy diet, exercise and not smoking will slow the progress of the disease. Walking has been shown to reduce symptoms of PAD. Treatment options vary and depend on the overall health of the individual and the severity of the disease. If you have PAD, your physician should provide you with adequate information to help you understand all options.
THE VASCULAR DISEASE FOUNDATION
The Vascular Disease Foundation is a non-profit, educational organization dedicated to reducing death and disability from vascular diseases and improving vascular health for all Americans. We are continually developing educational information and other resources about vascular disease for medical professionals, the public, and for those affected by common vascular disorders. The Board of Directors of the Foundation includes leading experts in vascular care, including physicians, nurses, exercise specialists, researchers, and members of national vascular medical societies who have been active in fighting vascular disease for many years. The Foundation is dedicated to operating with minimal overhead expenses, choosing to apply funds to provide information and educational materials for the public.
The Vascular Disease Foundation is a non-profit, educational organization dedicated to reducing death and disability from vascular diseases and improving vascular health for all Americans. We are continually developing educational information and other resources about vascular disease for medical professionals, the public, and for those affected by common vascular disorders. The Board of Directors of the Foundation includes leading experts in vascular care, including physicians, nurses, exercise specialists, researchers, and members of national vascular medical societies who have been active in fighting vascular disease for many years. The Foundation is dedicated to operating with minimal overhead expenses, choosing to apply funds to provide information and educational materials for the public.
Vascular Disease Foundation:
Toll-Free:
888.VDF.4INFO
888.833.4463
Fax: 303.989.0200
E-mail:info@vdf.org
Web site: http://www.vdf.org/
Toll-Free:
888.VDF.4INFO
888.833.4463
Fax: 303.989.0200
E-mail:info@vdf.org
Web site: http://www.vdf.org/
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Arterial Blood Flow Studies of the Legs (Segmental Doppler Pressures)
- What is the test?
- How do I prepare for the test?
- What happens when the test is performed?
- What risks are there from the test?
- Must I do anything special after the test is over?
- How long is it before the result of the test is known?
What is the test?
People who have leg pain when exercising may need an evaluation to make sure they have normal blood flow through their leg arteries. Normally blood pressure is similar whether it is measured in the legs or in the arms. If blood pressure is lower in the legs, it usually means that cholesterol buildup inside the leg arteries is interfering with circulation. By taking accurate blood pressure measurements at different locations along your legs, your doctors can determine if you have any arterial narrowing and, if so, where.
In order to get accurate blood pressure measurements, your doctor uses a technique called Doppler ultrasound. Doppler ultrasound is a painless way to detect blood flowing through a small artery. It uses sound waves and a type of sonar detection system to make noise when blood flow is detected. For arterial studies of the legs (called segmental Doppler pressures), Doppler ultrasound is used in place of the stethoscope that doctors usually use when taking blood pressures.
How do I prepare for the test?
You may want to wear shorts for this exam, and your feet should be bare during the test. If you are not wearing shorts, you may have to change into a hospital gown.
What happens when the test is performed?
You lie on a table and a technician or doctor wraps blood pressure cuffs around one of your legs in four or five locations (including the thigh, calf, and ankle). He or she then squirts some clear jelly onto your skin to help the Doppler sensor (which resembles a wand or pen) slide around easily and to help conduct sound waves through your skin.
Each blood pressure cuff is inflated two times. The first time, the cuff is only inflated part way so that it exerts a gentle pressure on your leg. The cuff sends information to a computer about the size of your leg and how elastic your arteries seem to be as the pressure is increased. A wavy line that signifies your blood flow appears on a video screen.
The second time, each cuff is inflated to exert more pressure on your leg. This temporarily cuts off circulation in the leg. Many patients briefly experience some cramping pain in the calf or thigh (similar to the sensation you experience when a blood pressure cuff is inflated around your arm). As the cuff is deflated, the doctor places a Doppler sensor against your foot to detect the moment when blood flow starts up again. (When it does, you will hear a noise that sounds like your heartbeat.) Checking the air pressure of the deflating cuff at this time shows the leg blood pressure.
After all the cuffs on one side have been tested, the other leg is checked in the same way. For comparison, you also have your blood pressure checked in each arm using the Doppler Technique. The whole test usually takes 45 minutes.
Some patients have their leg pressures checked both before and after exercise. If this is the case for your test, you are asked to walk on a treadmill for a short time and then have the test again afterward. The exercise version of this test takes more time.
What risks are there from the test?
There are no risks.
Must I do anything special after the test is over?
The jelly will be wiped off. You will have no side effects from the test.
How long is it before the result of the test is known?
Your doctor should receive a formal report within a few days.
