If you have symptoms of PAD/PVD, or if you have risk factors without symptoms, your doctor may do an exam along with tests to help with diagnosis. During an exam, your doctor will:
- Check the pulses in both your legs
- Listen to the blood flow in your legs with a stethoscope
- Check your legs and feet for swelling, sores and pale skin
Your doctor may also perform certain tests.
An angiogram is a special test doctors use to see how blood moves through your blood vessels. A special dye called contrast is injected into your body. Imaging technology then allows doctors to see where your blood is flowing and if there are narrowed areas or blockages that slow or prevent blood flow.
A CT angiogram, also called a CTA, is an imaging test that uses a CT scan and contrast dye to create detailed pictures of your blood vessels. This helps doctors see blockages, aneurysms or other problems inside arteries and veins throughout your body. During this test, you will lie on a table and an IV will be placed in your hand or arm. Contrast dye will be injected into the IV, and you will have painless electrodes attached to your chest. This will allow your medical team to monitor your heart rate and rhythm. The table slides into the CT machine, which takes a series of images from various angles. The procedure usually takes less than an hour.
A duplex ultrasound uses sound waves to create images of your blood vessels. It combines traditional ultrasound for structure with a Doppler technique that shows blood flow. This allows doctors to assess blood flow speed and direction to diagnose blockages, narrowing or abnormal flow patterns. During the test, you’ll lie on a table. The technologist will place a gel over the tissues being examined and then move a transducer wand over the area. Sound waves from the wand bounce off the tissues and back to a computer, which interprets the waves to create images. The test is painless.
A four-limb blood pressure measurement involves measuring blood pressure in both arms and both legs simultaneously while using a doppler ultrasound. This painless test allows doctors to assess blood flow and pressure differences between the arms and legs. By dividing the blood pressure reading of your ankle by the blood pressure reading from your arm, doctors can find your ankle-brachial index (ABI). An ABI of .9 or higher is acceptable, but an ABI of lower than .9 may mean that you have peripheral artery disease.
An MR angiogram, also known as magnetic resonance angiography (MRA), is a type of imaging test that uses strong magnets and radio waves to create detailed pictures of your blood vessels. Because it’s performed without the use of a catheter, an MRA is less painful and less invasive. MRA can help diagnose aneurysms, arterial stenosis and vascular malformations. During an MR angiogram, you lie on a table that slides into an MRI machine. You will remain still while the MRI is performed, which can take an hour or more. In some cases, you will have contrast dye injected into your blood vessels through an IV to make them easier to visualize during the test.
