Monday, November 29, 2010

Non-Invasive Vascular Studies: Take One!

Several months ago I blogged about Peripheral Arterial Disease (April 23, 2010: The Triad That Leads to P.A.D.), which is a disease of the circulatory system where blood flow to the periphery of the body, mainly the legs, is compromised or blocked secondary to a build-up of plaque within the vessel walls. The major risk factors that increase a patient’s chances of developing plaque build-up and subsequent Peripheral Arterial Disease are three: High Blood Pressure, High Cholesterol, and Smoking. Diabetes can also contribute to the disease, but keep in mind that although Peripheral Arterial Disease is commonly seen in the diabetic patient, it is not limited to that patient population alone.

In that blog it was mentioned that non-invasive Vascular Studies could be completed when pulses in the feet were non-palpable to your Podiatrist. These non-invasive tests can help to determine the amount of blood flow, while predicting blockages or occlusions within the main vessels carrying blood to the legs, feet and toes.

The first and most basic test that is typically ordered is called an “Ankle-Brachial Index,” or ABI as it is referred to in the medicine world. This test is performed using a simple blood pressure cuff, first applied around the arm to determine the blood pressure in the arm, and next applied to the calf to determine the blood pressure in the leg. The test is performed with the patient lying flat on a bed, usually on their back and will only take a few minutes to perform. The test is also painless, although some patients may experience minimal discomfort with inflation of the blood pressure cuff, which will be relieved upon deflation.

A second test, and one that is typically performed in conjunction with an ABI, is called a Pulse Volume Recording (PVR). As the heart beats, blood is “pulsed” throughout the body and when measured in the lower extremities by the PVR test, the values obtained can help indicate areas where the blood flows best and areas where there may be disruptions in blood flow. The test is performed by applying multiple blood pressure cuffs at intervals down the legs, and jas with ABI testing; it is a painless exam and is tolerated well by most all patients.

Together the information obtained in the ABI and PVR tests can help determine how well blood is flowing down into the legs and will indicate if there is narrowing or blockage of the vessels in any areas. It will also help determine how progressed your Peripheral Arterial Disease is and will guide treatment of the disease specifically for you!

At Advanced Footcare Centers, LLP Ankle Brachial Indices and Pulse Volume Recordings are completed in the office and your information is electronically sent via BioMedix PADnet, through our Collaborative Care Network. The Collaborative Care Approach ensures that the appropriate physicians managing your care, including a vascular surgeon and your primary care physician, all have access to the information obtained via these tests. Thus, they can work together on finding the best solution to managing your early or progressed Peripheral Arterial Disease.

For more information on the Collaborative Care Network with PADnet and BioMedix, of for more information on Peripheral Arterial Disease, click on the link below. If you have questions or concerns about the blood flow to your extremities, contact your Advanced Footcare Center Podiatrist today!

http://www.biomedix.com/collaborative_care_model.asp