Diagnosing Peripheral Artery Disease

In previous blog posts, we’ve discussed patient stories and described symptoms of peripheral artery disease (PAD). Today, we’ll focus on what types of patients are candidates for screening and treatment, and the types of screening methods available.

Risk factors for PAD include people who are over the age of 70, over the age of 50 and suffering from diabetes, and smokers. In some cases, people under the age of 50 may be at risk, particularly if they’re obese, suffering from diabetes, or if they have high blood pressure.  High cholesterol or a family history of the disease also increases the risk of developing PAD.

If we suspect that you have PAD, we’ll perform one or more of the following tests:

General physical exam:

Here, we’ll examine your body in an attempt to pinpoint any potential signs of PAD. This typically includes checking the pulse (particularly below the suspected weakened artery), listening for sounds over your arteries, checking your blood pressure, and tapping areas of your body to assess the level of fluid in your organs.

Doppler Ultrasound:

The Doppler Ultrasound test gauges the blood flow within the arteries in your arms and legs. It can diagnose arteriosclerosis, blood clots and artery blockages, and venous insufficiency or occlusion.

Angiography:

With angiography, we insert a dye into your blood vessels, which enables us to view the flow of blood though your arteries. During the procedure, X-rays are taken, or MRA (magnetic resonance angiography) may be used to follow the flow of the dye. Additionally, a catheter may be used (this is referred to as catheter angiography), and inserted into the groin area and into the area of the body being examined. While this particular method is a bit more invasive, it’s also beneficial in that we can treat the area in question while we examine it by inserting medication or opening partially blocked arteries with a stent or balloon.

Ankle-brachial index:

The ankle-brachial test measures the blood pressure at your ankle and compares it to the blood pressure in your arm. Your blood pressure is measured before and after you walk on a treadmill to determine whether PAD is present. The ABI test is considered to be one of the most reliable for determining the presence of PAD.

These are the main tests that we typically perform in order to diagnose and evaluate PAD; however, additional tests may be necessary.

Do you have questions about how we diagnose PAD? If so, feel free to ask away in the comments section.

About Dr. Joseph Ricotta, MD:

Dr. Ricotta specializes in vascular and endovascular surgery, and came to Emory from the Mayo Clinic in August 2010.  His areas of clinical interest include fenestrated and branched endografts to treat aortic aneurysms, thoracoabdominal aortic aneurysms, peripheral aneurysms, PAD, carotid endarterectomy and carotid stenting, mesenteric and renal artery disease, and venous diseases. He holds organizational leadership memberships at the American Medical Association, the American College of Surgeons, the Society for Clinical Vascular Surgery, and the Society for Vascular Surgery.

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