Ankle - Brachial Index
The ankle-brachial index (ABI) is a noninvasive diagnostic test used to determine an individual's risk for peripheral artery disease, or PAD. It can also help determine the severity or progress of the disease if it has already been diagnosed. This test is done by comparing the blood pressure in the ankle with the blood pressure in the arm. Since PAD is a condition that involves a narrowing or blockage of arteries in the leg, a low ankle-brachial index may indicate narrowed arteries in the legs. The ankle-brachial index is an important test since PAD is a dangerous condition which can lead to heart attack or stroke.
Candidates for Ankle-Brachial Index
Individuals may have risk factors for PAD, making the probability of developing the disease more likely. These risk factors may include:
- Being age 50 or older
- Being a current or former smoker
- Being overweight
- Having diabetes
- Having high blood pressure
- Having high cholesterol
Individuals who have poor circulation, experience leg pain and/or have other risk factors for PAD, should have an ankle brachial index test performed.
The Ankle-Brachial Index Procedure
The ankle-brachial index is a simple, safe and non-invasive procedure with no risks or side effects. Sometimes this test is performed in conjunction with two other procedures that check for blocked or narrow arteries elsewhere in the body: a carotid ultrasound and an abdominal ultrasound. The ankle-brachial index evaluates blood flow in a patient complaining of leg or arm pain, numbness, tingling and fatigue, all of which are symptoms of narrowing, hardening and blockage of the arteries. Doppler technology uses sound waves to detect blood flow, and identify any differences in blood pressure, in the arms and legs. During the arterial Doppler ultrasound, a transducer is used to detect blood flow before and after a blood-pressure cuff is inflated. Patients may experience mild cramping because the cuffs cut off circulation. ABI using Doppler ultrasound usually takes about 45 minutes to perform, and patients can return to their regular activities immediately afterwards.
Lower Extremity Arterial & Venous Ultrasound
Vascular disease is a serious condition that involves abnormal functioning within the veins of the legs, which can lead to complications such as aneurysm and stroke. A venous ultrasound provides diagnostic images of the vessels within the lower extremities, most commonly used to diagnose peripheral vascular disease. This procedure can identify narrowed or blocked arteries or veins and is essential in achieving successful vein treatment.
Many patients may experience significant vein reflux that can only be detected through ultrasound imaging. A venous ultrasound can show a thorough, detailed image of the veins, along with the direction of blood flow to help accurately diagnose vascular conditions. In addition to its diagnostic purpose, venous ultrasound can also be used to place a needle or catheter in a vein and plan the removal of narrowed or blocked veins.
Once the results have been analyzed, your doctor will determine a personalized treatment plan to relieve swelling, pain and other symptoms, and to relieve any blockages within the legs to ensure proper blood flow.
Ultrasound is a primary diagnostic and visualization tool because of its convenience, safety and effectiveness. Ultrasound produces images of internal structures through the use of high-frequency sound waves, whose echoes are used to create moving and still images.
This visualization allows the doctor to target the location and precise nature of the problem area. Additionally, all image recording happens in real time as soon as the machine is turned on and placed on the body. There is no wait for any sort of picture development needed for X-rays and other imaging procedures.
How It Works
The ultrasound procedure begins with the patient lying down on the examination table as a water-based gel is applied to the area on their body that will be observed. This gel allows consistent contact between the body and the transducer, free of any air pockets that could get in the way. The transducer is kept firmly against the skin and is moved back and forth across the area to allow for the most detailed observation possible. The whole procedure usually takes 30 minutes.
There is no discomfort associated with this procedure, although if the part of your body being observed has already been tender there may be some slight pressure against it. If a Doppler type ultrasound is used, you may actually hear the pulses of the device. There is no clinical risk inherent in ultrasonography as it uses no invasive methods or ionizing radiation and does not cause any health problems.