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January 20, 2010 > Painless Tests Help Detect Peripheral Artery Disease

Painless Tests Help Detect Peripheral Artery Disease

Most people know about arteriosclerosis, a narrowing or blockage of one or more arteries that supply blood to the heart. Left untreated, this condition can lead to a heart attack. You may also have heard that arteriosclerosis of an artery leading to the brain can result in a stroke. But, did you know about a similar condition that can occur in the arteries that supply blood to the legs? It's called peripheral vascular disease (PVD) or peripheral artery disease.

PVD is caused by an obstruction or partial obstruction due to plaque build-up in any of the arteries other than those leading to the heart or brain.

"Most often, this condition occurs in the arteries of the pelvis or legs," says radiologist Jason Cheng, M.D., of Washington Hospital's Outpatient Imaging Department. "As a result, less blood reaches the affected leg and, over time, the leg functions more poorly. If not treated, the condition can have a significant impact on the person's quality of life. Patients may develop pain in the legs with exertion. In severe cases, patients may even develop pain at rest and there is a risk of amputation due to gangrene. People with PVD are also at higher risk of having a heart attack or stroke and preventative measures should be taken to reduce these risks."

Painless Testing Options

A good way to check for PVD is to have a screening test. One painless, non-invasive method performed by the Outpatient Imaging Department at Washington Hospital is called Segmental Doppler Pressures. This test uses reflected sound waves to measure blood flow through the major arteries and veins to detect blocked or narrowed areas. By checking blood pressures at different places in the leg from the high thigh down to the ankle, the Doppler Ultrasound can identify changes, which may indicate a possible area of narrowing or blockage.

"Your blood vessels are much like plumbing," explains Doctor Cheng. "A blockage between point A and point B causes a drop in pressure."

One relatively simple screening test for PVD is the Ankle Brachial Index. In this test, the blood pressure in the ankles is compared with the blood pressure in the arms to see if there is an abnormal decrease, which indicates the presence of a blockage. The Segmental Pressures exam performed at Washington is a more sophisticated version of this test checking pressures at a number of points in each leg and not just the pressure at the ankles alone. The pressures not only give your physician an indication if disease or blockage is present but some idea of the likely severity of the problem. In addition, they indicate whether you are at risk for more serious complications such as poor healing of wounds, ulcers or even amputation.

Recently, the Hospital added a second test as part of its peripheral vascular screening. Called a Pulse-Volume Recording, the procedure increases the reliability of PVD screening and can detect some blockages that may be missed by the Doppler Ultrasound. The AHA and the American College of Cardiologists both recommend that people, especially smokers and those at risk for diabetes, should have both tests to check for PVD.

"Some people can develop blockages formed of calcium, which may not cause blood pressure in the leg to change and can therefore be missed with the Doppler pressures alone," says Dr. Cheng.

Could You Suffer From PVD?

Work with your physician if you have any concerns about PVD. For more information about the PVD screening tests that are performed at the Washington Outpatient Imaging Center, please call (510) 608-1380 or visit

This article is also featured in the current issue of Health Signs, a quarterly magazine published by Washington Hospital Healthcare System. If you would like to be added to the Health Signs mailing list, please call Washington Hospital's Community Relations Department at (510) 791-3417.

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