Peripheral Vascular Disease

Diagnosis

The following tools may be used to diagnose peripheral vascular disease:

Physical examination and bloodwork
A detailed medical history will include an assessment of risk factors for PVD, heart disease and stroke. The physician's questions will help identify symptoms of intermittent claudication (leg pain with walking) and other related medical conditions.

The physician will check blood pressure, pulses in the arms and legs, and examine for bruits (whooshing sounds heard with a stethoscope), which may indicate restricted blood flow caused by narrowed arteries.

Blood tests may include cholesterol level, tests for diabetes, and other tests that may indicate a higher risk for hardening of the arteries such as homocystine.

Ankle/brachial index (ABI)
This noninvasive test compares the blood pressure between the arms and the legs; an abnormal ratio may indicate decreased circulation.

Ultrasound
Ultrasound is a painless, noninvasive procedure that sends high-frequency sound waves into the arteries. As the sound waves bounce back, the technologist and physician can analyze the images and assess the degree of circulatory impairment. Ultrasound is used to evaluate the carotid arteries, intestinal and renal (kidney) arteries, and those to the arms and legs.

Computerized tomography/angiography (CTA) scanning
In this noninvasive test, a specialized X-ray machine (CT scan) rapidly rotates around the body, taking a series of images that are reconstructed, with the aid of a computer, to produce images of the arteries. Newly available 64-slice CT scanners can produce incredibly detailed views of the arteries and surrounding structures.

Magnetic resonance angiography (MRA)
This test uses a powerful magnet and radio waves to produce a detailed, three-dimensional view of the arteries. Narrowed and blocked arteries can be identified in this noninvasive test.

Arteriography
In this procedure, a catheter (thin, flexible tube) is inserted into the artery through a skin puncture, usually in the groin. The catheter is threaded, with X-ray guidance, through the circulatory tree to the affected artery. Contrast (dye) is injected into the artery to give a detailed view of problem areas. If a blockage or narrowing is discovered, it can occasionally be treated with a balloon or stent, often during the same procedure.