Vascular Ultrasound

What is a vascular ultrasound?

Vascular ultrasound is the umbrella name for a family of painless scans. Vascular simply means relating to blood vessels. The name covers arteries, veins, and the grafts and stents placed inside them. Every study in the family works the same way. A handheld probe called a transducer is pressed against the skin over the vessel. It sends high-frequency sound waves into the body and records the echoes that return. A computer turns those echoes into a picture of the vessel wall. Doppler adds the direction and the speed of the blood inside. Combining the two is why these are called duplex scans. Three things change from one study to the next. The vessel examined, how you are positioned, and what the sonographer looks for. That is why your order names a specific study. This page explains what the whole family has in common. The pages linked below cover each scan in detail.

These scans are available in our offices. That allows same-visit evaluation in many cases. Between them they find narrowing from plaque and blood clots. They also find leaking valves in veins, and weakened or bulging vessel walls. There is no radiation, no dye, no needles, and no sedation. Most studies take thirty to sixty minutes, depending on how many vessels are examined. Ultrasound is usually the first test ordered when circulation is in question, because it is safe and repeatable.

Why Dr. Nanavati may recommend this

The reasons depend on which vessels are involved. Arteries carry blood away from the heart, and veins carry it back.

Common reasons include:

• Leg pain or cramping that comes on with walking and eases with rest.
• Leg swelling, aching, heaviness, skin discoloration, or a wound that will not heal.
• Suspected blood clot in a deep vein, especially with sudden one-sided swelling.
• Screening for narrowing in the neck arteries, evaluated with a carotid ultrasound and Doppler.
• Reduced or absent pulses found during an exam.
• Follow-up after a bypass, a stent, or another vascular procedure.
• Watching a known aortic aneurysm over time.

Peripheral artery disease is common. It is often silent in its early stages. The National Heart, Lung, and Blood Institute explains why. Depending on the question, Dr. Nanavati may order an arterial ultrasound, a venous ultrasound, or an ankle brachial index measurement alongside the scan.

How to prepare

Most vascular ultrasounds need no preparation at all. A few specific studies do.

• For leg and neck studies, eat and drink normally and take your usual medicines.
• For abdominal vessel studies, including the aorta, expect to fast for about eight hours. Gas and food in the bowel block the sound waves.
• Wear loose, two-piece clothing. You may be asked to change into a gown for better access.
• Leave jewelry and watches at home, or plan to remove them near the area being scanned.
• Do not apply lotion, oil, or powder to the skin over the area being studied.
• Bring your medication list and any prior vascular imaging reports.
• Allow up to an hour, longer if both legs or several vessel groups are being studied.

What happens during the procedure

What every one of these scans shares is quick to describe. You lie on an exam table in a dimly lit room. Gel goes on the skin over the vessel. A probe glides across the gel. Images and flow readings are recorded, and the gel is wiped off at the end. Nothing is injected, and nothing is left behind.

What changes between studies is everything that actually matters to you on the day.

A carotid ultrasound is done lying flat with your head turned to one side. The neck has to be bare from the collarbone to the jaw. The probe stays light, and you may be asked not to swallow while a measurement is taken.

An arterial ultrasound of a leg works down the limb in segments, from the groin to the ankle. Both legs are usually compared against each other. Abdominal arteries need firmer pressure and a held breath, so the sonographer can see past bowel gas.

A venous ultrasound is the one where the probe presses down hard on purpose. A normal vein flattens shut under that pressure, while a vein holding a clot does not. The table is often tilted upright first, and part of a reflux study may be done standing.

If your appointment letter does not name the vessel, call the office before you come in. Preparation is not the same across the family. An abdominal study needs fasting, and a leg study does not.

Recovery and results

No study in this family has a recovery period. You dress and leave. Nothing was given that has to wear off. Driving, eating, work, and exercise are all fine right away.

The sonographer performs the scan, and a physician interprets it. Findings are compared with established measurements. One example is the speed of blood through a narrowed segment. That speed helps grade how significant the narrowing is. Reports are usually available within a few business days. Urgent findings are handled faster. A suspected deep vein clot is reported the same day so treatment can begin promptly. MedlinePlus describes why prompt treatment of a deep vein clot matters.

Dr. Nanavati will explain what was found and what it means for you. Mild findings often lead to monitoring and risk factor treatment, including cholesterol and blood pressure control. Moderate findings may prompt repeat scanning at set intervals. Significant findings can lead to further imaging. They can also lead to a referral for treatment, such as venous ablation or an arterial procedure.

Risks and safety

Safety is the one place where these studies really are interchangeable. None of them uses radiation. None uses contrast dye. None involves a needle or sedation. The questions that come with a CT scan do not arise here. There is no allergy history to check, no kidney function to clear, and no dose to keep track of. That is why ultrasound is normally the first look at a circulation problem. It is also why a finding can be followed with repeat scans for years.

Comfort varies more than safety does. Gel feels cool going on. Probe pressure is felt most in a leg that is already swollen or inflamed. The compression part of a vein study is where people notice it most. Lying still for up to an hour is the real complaint for people with back or hip pain. Tell the sonographer, because the table and the pillows can be adjusted.

The shared limitation is simple. Sound has to reach the vessel in order to report on it. Anything in the way weakens the picture. Bowel gas, a cast, a dressing, or an open wound will all block the beam. So will heavy swelling and dense calcium in an artery wall. Depth matters too. A vessel far below the surface is harder to see clearly than one near the skin.

Sometimes a scan cannot answer the question. The next step is then a test that does not rely on sound at all. That is most often CT or MR angiography. Moving on to it is a normal part of a workup, not a sign that anything went wrong.

Related services and conditions

• Carotid ultrasound and Doppler for the neck arteries and stroke risk.
• Arterial ultrasound for reduced blood flow to the arms and legs.
• Venous ultrasound for clots and leaking vein valves.
• Venous ablation for symptomatic varicose veins.
• Echocardiogram when the heart itself needs assessment.
• Advanced lipid testing to guide cholesterol treatment.
• Cardiology services offered at each of our offices.
• Request an appointment online