TESTING

Specific diagnostic tests used at VDC:
Your referring doctor may order one of a number of diagnostic tests to accurately diagnose vascular disease. Noninvasive testing often eliminates the need for invasive procedures, including surgery.

The following section is useful in determining which test is most likely to be of help when a particular symptom is present or when a particular diagnosis is suspected.

Cerebrovascular Exams (including evaluation of vertebral arteries) are performed in patients with the following symptoms or suspected disease:
● Asymptomatic carotid bruit
● Transient ischemic attack
● Localization of vascular disease and determination of plaque morphology
● Patients suspected of being at high risk for stroke
● Patients suspected with vertebrobasilar insufficiency
● Systematic tracking of patients with medically treated carotid disease
● Prior to certain major operations
● Atypical neurological symptoms

Peripheral Arterial Exams
Lower extremity tests are performed in patients with the following symptoms or suspected disease:
● Claudication limits
● To distinguish true claudication from pseudoclaudication
● To determine the degree of disability
● To determine efficiency of collateral circulation
● For post-operative follow-up
● Patients experiencing diabetic rest pain, ischemia
● Patients with lesion that want heal
● Patients experience trauma to extremity with possible arterial involvement
● Indication of healing of foot surgery in older patients
● Information for level of limb amputation
● Leg pain with unknown etiology

Upper extremities are performed in patients with the following symptoms or suspected disease:
● Suspected subclavian stenosis (brachial systolic blood pressure difference)
● Manifest or suspected arterial insufficiency of the extremity
● Suspected thoracic outlet syndrome
● Vasospastic disease (digital arterial exam)

Deep Abdominal Exams are performed in patients with the following symptoms or suspected disease:  Renal Artery Vascular Insufficiency
● Suspected renal artery vascular insufficiency
● Suspected primary parenchymal disease
● Evaluation of natural history of renal artery occlusive disease
● Post-operative evaluation of flow patterns in renal artery bypass patients
● Unexplained hypertension

Abdominal Aortic Aneurysm
● Suspected abdominal aortic aneurysm
● Evaluation of natural history of AAA
● Overly pulsatile aorta
● Unexplained lower-right quadrant back pain

Aorto-iliac Vascular Insufficiency
● Suspected aorto-iliac origin chronic arterial insufficiency
● To determine the extent of blockage and its consequences on blood flow
● Assess patency and flow patterns following revascularization procedures
● Evaluation of natural history of aorto-iliac arterial insufficiency

Mesenteric/Celiac Artery
● Suspected mesenteric/celiac occlusive disease
● Assess patency and flow patterns following revascularization procedures
● Evaluation of the natural history of mesenteric occlusive disease
● Post-prandial abdominal pain in older patients

Peripheral Venous Exams are performed in patients with the following symptoms or suspected disease:
● To follow-up anticoagulant therapy
● Suspected thrombophlebitis (DVT)
● Leg swelling with unknown etiology
● Screening prior to venogram
● Trauma to the extremity with possible venous involvement
● To assess patients with combined arterial and chronic venous insufficiency
● Screening patient with uncharacteristic leg symptoms
● Periodic monitoring of patients at high risk for thromboembolic complications for the
  detection of clinically silent deep venous thrombosis
● Evaluation prior to surgery
● Making differential diagnosis between recurrent acute DVT&post-phlebitic syndrome
  due to chronic venous occlusion or incompetent valves

Additional tests provided at VDC:
● Impotency evaluation
● Suspected testicular torsion
● Transcutaneous Oxygen Measurement (TCOM)