Robert Wood Johnson University Hospital
 

Vascular Studies

Heart Procedures - Vascular Studies

(Carotid, Arm, and Leg Arterial and Venous Studies, Carotid Ultrasound, Venous Doppler Studies, Arterial Doppler Studies, Pulse Volume Recordings, PVRS)

Procedure Overview

What are vascular studies?

Vascular studies are a noninvasive (the skin is not pierced) procedure used to assess the blood flow in arteries and veins. A transducer (like a microphone) sends out ultrasonic sound waves at a frequency too high to be heard. When the transducer is placed on the skin at certain locations and angles, the ultrasonic sound waves move through the skin and other body tissues to the blood vessels, where the waves echo off of the blood cells. The transducer picks up the reflected waves and sends them to an amplifier, which makes the ultrasonic sound waves audible.

Vascular studies can utilize one of these special types of ultrasound technology, as listed below:

Illustration of a carotid artery duplex scan
Click Image to Enlarge

To assess blood flow in the limbs, pulse volume recordings (PVRs) may be performed. Blood pressure cuffs are inflated on the limb and blood pressure in the limb is measured using the Doppler transducer.

To assess the carotid arteries in the neck, a carotid duplex scan may be performed. This type of Doppler examination provides a 2-dimensional (2D) image of the arteries so that the structure of the arteries and location of an occlusion can be determined, as well as the degree of blood flow.

A carotid artery duplex scan is a type of vascular ultrasound study done to assess occlusion (blockage) or stenosis (narrowing) of the carotid arteries of the neck and/or the branches of the carotid artery. Plaque (a build up of fatty materials), a thrombus (blood clot), and other substances in the blood stream may cause a disturbance in the blood flow through the carotid arteries.

Other related procedures that may be used to assess the heart and circulatory system include resting and exercise electrocardiogram (ECG or EKG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest x-ray, computed tomography (CT scan) of the chest, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and ultrafast CT scan. Please see these procedures for additional information.

Vascular conditions:

The arteries bring oxygen and other nutrients to the cells of the body. The veins take away the blood after the cells have taken in the oxygen and nutrients and given up their waste products, such as carbon dioxide. If blood flow is decreased to any part of the body, that area does not get enough oxygen and nutrients and is unable to get rid of its waste products adequately.

Illustration of a normal and diseased artery
Click Image to Enlarge

Decreased blood flow can occur in the arteries and veins anywhere in the body, such as the neck and brain. When the neck arteries (carotid arteries) become occluded, symptoms such as dizziness, confusion, drowsiness, headache, and/or a brief loss of ability to speak or move, may be the early warning signs of a possible stroke (brain attack). More severe symptoms, such as sudden sharp headache, loss of vision in one eye, sudden loss of ability to move arms, legs, or one side of the body, sudden forceful vomiting, or sudden decreased level of consciousness may mean that a stroke is imminent.

Some conditions which may affect blood flow include, but are not limited to, the following:

Any of these conditions may cause decreased blood flow in arteries and/or veins. Some symptoms that may occur when blood flow decreases to the legs include, but are not limited to, the following:

If the physician suspects that a person may have decreased blood flow somewhere in the peripheral (arms, legs, and/or neck) circulation, vascular studies may be performed.

Reasons for the Procedure

Reasons for which vascular studies may be performed include, but are not limited to, the following:

There may be other reasons for your physician to recommend a vascular study.

Risks of the Procedure

There is no radiation used and generally no discomfort from the application of the ultrasound transducer to the skin.

For some patients, having to lie still on the examination table for the length of the procedure may cause some discomfort or pain.

There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Certain factors or conditions may interfere with a vascular study. These factors include, but are not limited to, the following:

Before the Procedure

During the Procedure

A vascular study may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a vascular study follows this process:

  1. You will be asked to remove any jewelry or other objects that may interfere with the procedure. You may wear your glasses, dentures, or hearing aid if you use any of these.
  2. If you are asked to remove clothing, you will be given a gown to wear.
  3. You will lie on an exam table or bed.
  4. A clear gel will be placed on the skin at locations where the pulse is expected to be heard.
  5. The Doppler transducer will be pressed against the skin and moved around over the area of the artery or vein being studied.
  6. When blood flow is detected, you will hear a "whoosh, whoosh" sound. The probe will be moved around to compare blood flow in different areas of the artery or vein.
  7. For arterial studies of the legs, blood pressure cuffs will be applied in three positions on the leg in order to compare the blood pressure between different areas of the leg. The cuff around the thigh will be inflated first, and the blood pressure will be determined with the Doppler transducer placed just below the cuff.
  8. The cuff around the calf will be inflated, and the blood pressure will be determined as with the thigh cuff.
  9. The cuff around the ankle will be inflated, and the blood pressure will be determined as in steps #6 and #7.
  10. The blood pressure will be taken in the arm on the same side as the leg that was just studied and used to determine the degree of any occlusion of arterial flow in the legs.
  11. Once the procedure has been completed, the gel will be removed from the skin.

The technologist will use all possible comfort measures and complete the procedure as quickly as possible to minimize any discomfort.

After the Procedure

You may resume your usual diet and activities unless your physician advises you differently.

Generally, there is no special type of care following a vascular study. However, your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Online Resources

The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.

This page contains links to other Web sites with information about this procedure and related health conditions. We hope you find these sites helpful, but please remember we do not control or endorse the information presented on these Web sites, nor do these sites endorse the information contained here.

American College of Cardiology

American Heart Association

American Stroke Association

National Cholesterol Education Program

National Heart, Lung, and Blood Institute (NHLBI)

National Institute of Neurological Disorders and Stroke

National Institutes of Health (NIH)

National Library of Medicine

National Stroke Association

Click here to view the
Online Resources of Heart Center

 

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