Non-invasive diagnostic tests

 

Ankle Brachial Index (ABI)

The ankle-brachial index test is a quick, noninvasive way to check for P.A.D. The disease occurs when blood flow to your lower extremities has been reduced. The ankle-brachial index test compares the blood pressure measured at your ankle with the blood pressure measured at your arm. The lower the ABI number, the higher your chances of having P.A.D. or other arterial deficiencies.

Lower Extremity Arterial & Venous Ultrasound

An ultrasound is a procedure that uses sound waves to "see" inside your body. An arterial or venous ultrasound uses sound waves to create a color map of the arteries and veins in your legs to identify issues such a plaque buildup,  narrowed arteries or other conditions such as deep venous thrombosis.

Abdominal Aorta Ultrasound

An ultrasound of the abdominal aorta is a non-invasive, painless test that uses sound waves to map the aorta, which is the main artery leading away from the heart. When the walls of the abdominal aorta become weak, they may balloon outward If the aorta reaches over 3 centimeters in diameter, it is then called an abdominal aortic aneurysm (AAA). 

Renal Artery Ultrasound

A renal artery ultrasound is a non-invasive, painless test that uses sound waves to map your renal arteries. These are the arteries that supply oxygenated blood to your kidneys. 

Iliac and Inferior Vena Cava Venous Ultrasound

A vascular ultrasound of the inferior vena cava and iliac veins is a non-invasive, painless test that uses sound waves to map the inferior vena cava and iliac veins, which supply blood flow to your abdomen and pelvis.  

Carotid Ultrasound

A carotid artery ultrasound is a non-invasive, painless test that uses sound waves to map your carotid arteries. The carotid arteries are major blood vessels in the neck that supply blood to the brain, neck, and face. There are two carotid arteries, one on the right and one on the left. 

An echocardiogram is a non-invasive test that uses ultrasound to map images of your heart. The test is also called a diagnostic cardiac ultrasound. An echocardiogram uses sound waves to create digital images of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart.

Therapeutic Invasive Procedures

Lower Extremity Angiogram

A lower extremity angiogram, also known as a peripheral angiogram, is a test that uses X-rays and dye to help find narrowed or blocked areas in one or more of the arteries that supply blood to your legs. Typically, a peripheral angiogram will be performed in conjunction with a lower extremity balloon angioplasty or lower extremity atherectomy. 

 

Lower Extremity Balloon Angioplasty

A balloon angioplasty is one of the most common treatments for P.A.D. A catheter is inserted into the affected artery and is guided to the blockage via X-ray. When it reaches the blockage, a small balloon on the tip of the catheter inflates to push the plaque against the artery wall and widens the space for blood to flow. Many times weakened artery walls will require a stent to be placed. 

 

Lower Extremity Atherectomy

A lower extremity atherectomy is a procedure using a wire catheter to clean out plaque from highly calcified arteries. There are four types of atherectomies performed at Mission Vascular & Vein Institute:

  • Directional: A directional atherectomy utilizes SilverHawk technology with carbide disks to remove plaque build-up. The SilverHawk plaque excision system is a forward-cutting, directional atherectomy device that consists of a rotating blade inside a tubular housing with a collection area.
     

  • Laser: A laser atherectomy uses a fiber catheter equipped with a laser tip that breaks up artery plaque by emitting high-frequency light via the laser. 
     

  • Rotational: Mission Vascular & Vein Institute utilizes Pheonix technology with an over-the-wire device with a rotating, front-cutting element located on the distal tip of the catheter that shaves material directly into the catheter where it is captured and continuously removed by an internal Archimedes screw into an external collection bag. 
     

  • Orbital: Mission Vascular & Vein Institute utilizes the Diamonback360 for orbital atherectomies. An orbital atherectomy utilizes a diamond-coated tungsten crown that orbits 360 degrees eccentrically within the vessel and uses circumferential sanding to remove plaque buildup.

    Each patient with PAD presents with his or her own set of unique characteristics and challenges. Each procedure will be personally tailored to each individual patient and their condition.

 

Peripheral Extremity Stent Placement

Lower extremity stents are small wire mesh "tubes" that prop open arteries or veins. Stents are oftentimes used in conjunction with a balloon angioplasty. ​The .wire stent holds weak or damages arteries open so blood can flow through more fluidly. A stent is passed through a catheter and implanted in the peripheral artery or vein.

IVUS (Intravascular Ultrasound)

Intravascular ultrasound (IVUS) is an ultrasound from inside of an artery. IVUS uses sound waves to produce an image of the coronary arteries and to see their condition. An IVUS is done on the tip of a catheter and provides a more detailed image of blockage within an artery than what is available via a standard echocardiogram.

 
 

Lower Extremity Thrombectomy

A peripheral or lower extremity thrombectomy is a procedure used to remove a blood clot from an artery. Similar to an atherectomy, the procedure uses a catheter with specialized equipment to clean out the affected artery. 

 

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