Tests for Peripheral Vascular Disease

There are some relatively simple tests that can be done to determine if your arterial blood flow in you legs is normal.  PVD diagnosis begins with a physical examination.  Your doctor may perform or recommend one of the following tests:

  • Ankle-brachial index (ABI):  a simple, painless non-invasive exam that compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing.  This test only requires a few minutes and can be performed by your healthcare professional as part of a routine exam.  Normally the ankle pressure is at least 90 percent of the arm pressure, but with severe narrowing of the vessels in your lower legs it may be less than 50 percent.

If an ABI result is an abnormal ratio between the blood pressure of the ankle and arm, you may need more testing.  Your doctor may recommend one of the following tests:

  • Doppler and Ultrasound imaging:  a non-invasive method that visualizes the artery with sound waves and measures the blood flow of an artery to indicate the presence of a blockage.
  • Computed Tomographic Angiography (CT):  a non-invasive test that can show the arteries in your abdomen, pelvis and legs.  A computer and X-rays are used to generate the images.  This test is useful in patients with pacemakers or stents.
  • Magnetic Resonance Angiography (MRA):  a non-invasive test that provides information similar to that of a CT without using X-rays.  MRA uses a large magnet to produce clear images of arteries in your abdomen, pelvis and legs
  • Angiography (Peripheral Angiography) is another test that can be used but is usually reserved for use in conjunction with treatment.  Angiography is the X-ray study of the inside of the heart and blood vessels. It is done by inserting a catheter in the blood vessel and injecting a radiographic contrast material, or dye.

    PVD often goes undiagnosed. This can be dangerous because PVD can lead to painful symptoms, loss of a leg and/or increased risk of coronary artery disease and carotid atherosclerosis.  Since people with PVD have an increase risk for heart attack and stroke, the American Heart Association encourages people at risk to discuss PVD with their health care professional to ensure early diagnosis and treatment.

Treatments for Peripheral Artery Disease

The best treatment for PVD depends on a number of factors, including overall health, and the location, size and cause of the blockage. In some cases, lifestyle changes can be enough to slow the progress and manage PVD. However, some patients will need surgery or a less invasive approach such as an angioplasty to restore the blood flow to their legs. Your physician will recommend the best treatment for your condition.

Angioplasty - a non surgical approach to open clogged or narrowed arteries using balloons and stents.
Directional Atherectomy - Instrument used to open clogged arteries.
Peripheral Bypass Surgery - A vein graft is used to create a new route for blood to flow around the artery.
Rotational Atherectomy - Instrument used to open clogged arteries.

Another treatment option for PVD at Genesis includes the use of a Laser to vaporize the blocked artery. Physicians at Genesis use the Excimer Laser System® from Spectranetics. With cool laser therapy a small fiber optic catheter is moved to the top, or cap, of the blockage in the artery. When the catheter reaches the blockage site it transmits short bursts of "cool" ultraviolet energy through the flexible fibers of the catheter. The ultraviolet energy penetrates the top of the lesion, vaporizing a small portion of the blockage.

The laser catheter moves slowly through the blockage, one millimeter per second, vaporizing the blockage. Most laser procedures are also followed with additional angioplasty and possible stent placement.