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Vascular Laboratory

What is Peripheral Artery Disease (PAD)?

PAD is very common in the arteries of the pelvis and legs. It is a narrowing of the blood vessels to the legs which is caused by a buildup of fatty plaque. PAD may show up in arteries before there are any signs or symptoms. The arteries become narrowed and blood flow decreases with PAD.

  • Peripheral Artery Disease increases your risk of heart attack and stroke.

  • PAD is a common disease among those over 50 years of age.

Warning Signs

Unfortunately, there are often no symptoms or warning signs for Peripheral Artery Disease. Research has shown that nearly 75% of people with PAD do not experience symptoms. Women are less likely to have symptoms than men. However, you may want to keep the following symptoms in mind:

  • The most common symptom of PAD is painful cramping in the buttocks, hips, thighs or calves when walking, climbing stairs or exercising;

  • Constant leg pain, tingling, burning or loss of sensation.

Many people dismiss leg pain as a normal sign of aging. You may think it is arthritis or stiffness from aging. PAD leg pain occurs in the muscles, not the joints.

IF YOU HAVE ANY KIND OF RECURRING PAIN, SPEAK TO YOUR HEALTHCARE PROFESSIONAL AND DESCRIBE THE PAIN AS ACCURATELY AS POSSIBLE.

  • Foot pain that does not go away when you stop exercising;

  • Foot or toe wounds that will not heal or heal very slowly;

  • A marked decrease in the temperature of your lower leg or foot;

  • Gangrene.

Risk Factors:

There are certain risk factors for PAD which cannot be controlled, such as aging or having a personal or family history of PAD, cardiovascular disease or stroke. However, there are many risk factors you can control including:

  • Cigarette Smoking

  • Obesity

  • Diabetes Mellitus

  • High Blood Pressure

  • High Blood Cholesterol

  • Lack of Exercise

Chronic Kidney Disease

It is important to take care of all risk factors under your control, develop a heart healthy lifestyle and to cooperate with your healthcare professionals.

Diagnosis

PAD diagnosis begins with a physician examination. Your doctor will check for weak pulses in the legs. An ABI, or ankle-brachial index test is usually done. The exam is painless and compares the blood pressure in your feet to the pressure in your arms to determine how well the blood is flowing.

Treatment

Treatment for PAD focuses on reduction of symptoms and prevention of further progression of the disease. In many cases, lifestyle changes, exercise and medication are enough to slow the progression of the disease.

Exercise: The most effective treatment for PAD is regular exercise. Walking is one of the best forms of exercise.

Diet: Many PAD patients have elevated cholesterol levels. A diet low in saturated fat and cholesterol can help lower blood cholesterol levels.

Smoking Cessation: Smoking greatly increases your risk for PAD and your risk of a heart attack and stroke.

Medication: You can speak to your doctor regarding medication therapy.

Procedures: For some patients diet, exercise and medication may not be enough. Minimally invasive procedures consist of angioplasty, atherectomy or stent placement. These are non-surgical procedures where a needle puncture hole is made through which a catheter is inserted to reach the blocked artery. A tiny balloon is inflated inside the artery. An atherectomy may be performed to remove the plaque. A stent, a tiny wire mesh cylinder, may also be implated at this time to help hold the artery open.

Please contact your doctor if you have any of the symptoms or risk factors mentioned here.

Please click on the following to learn more about the non-evasive examinations we specialize in based on the symptoms associated with:



Pulse Volume Recording (PVR) and segmental blood pressure evaluations of the upper and lower extremities indirectly quantitate the severity of disease through physiological data analysis. Duplex ultrasound allows assessment of arterial flow, plaques, and aneurysm or dilated segments. Duplex ultrasound is also used to evaluate the patency of grafts and revascularizations. This allows for identification of graft stenosis or revascularization of native artery stenosis prior to occlusion and in some cases the identification of stenosis can lead to prophylactic intervention.

Symptoms for arterial examinations:

  • Patients with cramping in thigh, hip, buttock, or calf while walking relieved by rest

  • Absent pulses

  • Numbness or tingling of the extremity

  • Cold leg

  • Ulcers or non healing wounds (toes and ankles)



A duplex ultrasound of the upper or lower extremities is an excellent test for the evaluation for blood clots (DVT) and venous insufficiency. The test is highly accurate and painless to the patient. Follow up studies serial examinations will allow for the evaluation of thrombus propogation. Follow up studies are particularly useful in situations where one does not want to subject the patient to anticoagulation unless absolutely necessary. Venous insufficiency can cause unceration. Duplex untrasound can identify the etiology of this chronic condition thereby allowing appropriate treatment.

Symptoms for DVT:

  • Edema (new onset)

  • Calf pain (new onset)

  • Shortness of breath

  • Hot to touch (could be superficial thrombus)

  • Redness (could be superficial thrombus)


Venous insufficiency symptoms:

  • Edema (long term)

  • Varicose veins

  • Ulcers on legs above ankles

  • Hyperpigmentation


The function and commitment of Eastside Cardiovascular Medicine's laboratory is to provide accurate diagnostic information for detection and treatment of vascular disease in a safe and timely matter.

We are an Accredited  Vascular Labratory.

The studies we perform in the vascular lab are painless and safe; there are no dyes, shots, or radiation given to the patient. Our studies are more cost efficient then invasive testing procedures such as angiography.

Our vascular laboratory is staffed with Registered Vascular Sonographers and Technologists who are committed to achieving the highest level of expertise. We have highly dedicated and trained physicians who care and educate their patient's about vascular disease to assure them that they are getting the proper care and treatment that they deserve. We also offer clinical diagnostic testing to our referring doctors.



We Also Specialize In:

Cardiology
&
Electrophysiology

Click on the above links for more details about these concentrations & the newest innovative technologies our physicians on staff are trained in to better assist you.

 

 

Carotid Examination Images
Click on each for a larger view

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Lica with Disease

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Aortic Aneurysm

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Normal Internal
Carotid Artery


A duplex examination of the extracranial carotid arteries is a safe and accurate test for the identification of plague morphology and the degree of stenosis. It is safe and highly accurate.

Symptoms for evaluation:

  • Stroke

  • Bruit in the neck (heard by the doctor)

  • Dizziness/vertigo

  • Visual disturbances

  • Syncope

  • Slurred speech

  • Weakness or numbness on one side of the body (may only last a short time)

  • Facial droop



By a simple painless duplex examination the aorta and iliacs can be evaluated for the treatment of aneurysms and can be followed serially to evaluate changes in diameter accurately and in a cost-effective manner. Stenosis of the renal arteries causing renovascular hypertension or renal insufficiency can be identified as well.

Symptoms of abdominal aneurysms:

  • Palpable abdominal

  • Unexplained weightloss

Symptoms for renovascular hypertension:

  • Uncontrolled hypertension

 



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