TYPES OF TESTS

How can our services help you?

The tests that we provide are designed to determine whether or not you have blockages in the arteries or veins. The tests are diagnostic and not therapeutic. We can determine the location and extent of the blockage. This information is valuable for you and your Doctor, because with it a decision can be made as to the best way to fix the artery or vein.


Carotid, Vertebral, and Subclavian Artery Doppler :

This study determines accurate localization of disease in the extracranial carotid, vertebral and subclavian arteries, and classification of the extent of blockage and reduction of blood flow to the brain and upper extremities.

Indications:
- stroke, mini-stroke, bruit, dizziness, headaches, vertigo, loss of coordination, screening candidates for cardiac or vascular surgery, visual disturbances, pulsatile mass in the neck area, subclavian steal due to asymmetrical brachial pressures.

Preparation:
- None


Upper and Lower extremity Segmental Pressures:

The purpose of this study is to identify, localize and quantify obstruction in the arterial circulation to the arms or legs.

Indications:
- Arm, hand or digit pain at rest or with exertion; buttock, leg, foot or digit pain at rest or claudication pain; discoloration of skin or non-healing ulcers on ankle, foot, or digits due to possible ischemia; asymmetrical brachial pressures; reduced or absent pulses.

Preparation:
- None


Upper / Lower Extremity Arterial Duplex:

Duplex imaging is used to determine exact location and the extent of an arterial obstruction without angiography, permitting the Physician to discuss potential interventions with the patient.

Indications:
- Claudication with resting Ankle Brachial Index (ABI) less than .80 and exercise ABI less than .70.
- A .15 drop in ABIs when compared to previous study.
- Leg and/or arm pain, numbness or weakness with exertion.
- Loss of or reduced pulse in arm or leg.
- Cyanosis of digits, or cold extremity to the touch.
- Trauma to the extremity with suspected arterial injury.
- Asymmetrical Brachial pressures equal or greater than 20 mmHg (suggestive of Subclavian Steal).
- Postoperative evaluation of hemodialysis access graft or arterial bypass.
- Monitoring a bypass graft.
- After percutaneous interventions such as angioplasty, for monitoring or if symptoms change.
- Pulsatile mass in arm or leg.

Preparation:
- None


Upper and Lower Extremity Venous Duplex:

This study is to determine if a venous thrombosis is present in the superficial and/or deep veins of the extremity and to define its extent and location. Also to determine the extent of lower extremity venous valvular incompetency.

Indications:
- Extremity swelling, tenderness or pain.
- Neck swelling, tenderness or pain.
- Palpable subcutaneous "cord" in the extremity.
- Infusion difficulty with indwelling venous catheters.
- Post operative – with reduced ambulation.
- Chemotherapy – with complaint of extremity symptoms.
- History of DVT – with complaint of extremity symptoms.
- Removal or reduction in Anticoagulation therapy – with extremity symptoms.
- Concern with pulmonary emobolism.
- Chronic leg ulcers or stasis color changes in the leg.
- Varicose veins (preoperative scan).

Preparation:
- None


Mesenteric Artery Duplex:

To identify a hemodynamically significant stenosis of the arteries carrying blood to the intestines and correlate GI symptoms with the presence of intestinal ischemia. Also to monitor arterial blood flow after vascular reconstruction to the mesenteric arteries.

Indications:
- Abdominal pain and cramping associated with eating.
- Diarrhea of unknown etiology.
- Significant unexplained weight loss.
- Abdominal bruit.
- Unexplained gastrointestinal symptoms.
- Postoperative evaluation of vascular reconstruction.

Preparation:
- NPO 4 hours prior to the exam. If the patient is diabetic and unable to abide by this preparation, we will work with the patient. Please allow the patient to eat. Suggest to the patient that he/she eat as light a meal as possible and foods which are non-gas producing. If the patient must take diabetic medications just prior to eating, please ask them to bring the diabetic medications to the appointment.   Preferably schedule the patient in the AM.


Renal Artery Duplex:

To determine the presence of an arterial flow reducing renal artery stenosis (RAS) or occlusion and to identify high resistance arterial flow within the kidney, which suggests intrinsic parenchymal disease in hypertensive patients.

Indications:
- New onset of hypertension
- Uncontrolled hypertension
- Elevated BUN, Creatinine
- Abdominal bruit
- As a screen for renal artery stenosis prior to medical management with beta-blockers.
- Episode of flash pulmonary edema with unknown etiology.
- Prior to and as a follow-up for surgical revascularization or percutaneous transluminal dilatation of the renal arteries.

Preparation:
- NPO 4 hours prior to the exam. If the patient is diabetic and unable to abide by this preparation, we will work with the patient. Please allow the patient to eat. Suggest that he/she eat as light a meal as possible and foods which are non-gas producing.   If the patient must take diabetic medications just prior to eating, please ask them to bring the diabetic medications to the appointment.   Preferably schedule the patient in the AM.


Renal Vein Duplex:

To rule out renal vein thrombosis.

Indications:
- Patient with a known renal carcinoma with concern for extension into the renal vein.
- Inferior vena cava thrombus.
- Right atrial thrombus/mass

Preparation:
- NPO 4 hours prior to the exam. If the patient is diabetic and unable to abide by this preparation, we will work with the patient. Please allow the patient to eat. Suggest that he/she eat as light a meal as possible and foods which are non-gas producing.   If the patient must take diabetic medications just prior to eating, please ask them to bring the diabetic medications to the appointment.   Preferably schedule the patient in the AM.


Aortoiliac Duplex:

To determine the diameter of a possible aneurysm, evaluate suspected arterial occlusive disease, assess the development of an iliac pseudoaneurysm after a catherization, and to assess the patency of an aortoiliac bypass graft.

Indications:
- Pulsatile abdominal or inguinal mass.
- Abdominal bruit
- Claudication of the hip or buttock muscles.
- Penile erectile dysfunction
- Emboli resulting in ischemic lower extremity digits (to determine the source).
- Monitoring of an aortoiliac arterial obstruction.

Preparation:
- NPO 4 hours prior to the exam. If the patient is diabetic and unable to abide by this preparation, we will work with the patient. Please allow the patient to eat. Suggest that he/she eat as light a meal as possible and foods which are non-gas producing.   If the patient must take diabetic medications just prior to eating, please ask them to bring the diabetic medications to the appointment.   Preferably schedule the patient in the AM.


Inferior Vena Cava and Iliac Vein Duplex:

To rule out the presence of thrombus within the IVC and/or iliac veins in suspected proximal deep venous thrombosis, and to evaluate the patency of the IVC in patients who have a filter.

Indications:
- Routine follow-up of patients who have an IVC filter to evaluate the patency of the IVC below and above the filter.
- Bilateral lower extremity edema.
- Abdominal and/or pelvic post operative patients with lower extremity symptoms.

Preparation:
- NPO 4 hours prior to the exam. If the patient is diabetic and unable to abide by this preparation, we will work with the patient. Please allow the patient to eat. Suggest that he/she eat as light a meal as possible and foods which are non-gas producing.   If the patient must take diabetic medications just prior to eating, please ask them to bring the diabetic medications to the appointment.   Preferably schedule the patient in the AM.


Arterial Bypass Graft Surveillance Duplex:

To assess the patency of the bypass graft and determine the perfusion status of the distal aspect of the extremity.

Indications:
- Postoperative follow up.
- Return of arterial insufficiency symptoms:
- Increasing lower extremity claudication or upper extremity exertional symptoms.
- Ischemic digits or skin temperature changes.
- Extremity rest pain.
- Reduced or absent pulses
- Decrease in ABI greater than .15 from prior study.

Preparation:
- None


Hemodialysis Access Graft/Fistula Duplex:

To monitor the graft/fistula by ultrasound, and identify potential obstruction of the lumen, inflow and outflow anastomosis sites.

Indications:
- Increased venous pressure during dialysis
- Edema of the extremity
- Decreased thrill (palpable or audible)
- Localized area of dilatation (pseudoaneurysm)
- Aspiration of clot during needle insertion

Preparation:
- None