PAD Evaluation - Peripheral Artery Disease


What is PAD?

Peripheral artery disease, also known as peripheral arterial disease, is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease (PAD), your extremities - usually your legs - don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (intermittent claudication). Peripheral artery disease is also likely to be a sign of widespread accumulation of fatty deposits in your arteries (atherosclerosis). This condition may be reducing blood flow to your heart and brain, as well as your legs. Early diagnosis and treatment can prevent peripheral artery disease from getting worse and also help you reduce your risk of heart disease and stroke.

Patients who have blockages that develop in one group of blood vessels (heart, cartoid arteries, legs, kidneys) have a tendancy to develop blockages in the other areas as well. Therefor patients who have heart disease or carotid disease often need to be screened for PAD in their legs.

PAD Evaluation

Preparing for a PAD Evaluation

Impedance phlebography is a noninvasive test that uses electrical monitoring to measure blood flow in veins of the leg. Information from this test helps a doctor to detect deep vein thrombosis or blood clots. Patients undergoing this test do not need to alter their diet, change their normal activities, or stop taking any medications. Impedance phlebography works by measuring the resistance to the transmission of electrical energy (impedance). This resistance changes depending on the volume of blood flowing through the veins. By graphing the impedance, a doctor or technician can tell whether a clot is obstructing blood flow.

What happens during a PAD Evaluation?

Using conductive jelly, the examiner puts electrodes on the patient's calf. These electrodes are connected to an instrument called a plethysmograph, which records the changes in electrical resistance that occur during the test. The patient lies down and raises one leg at a 30 degree angle, so that the calf is above the level of the heart. The examiner wraps a pressure cuff around the patient's thigh and inflates it to a pressure of 45-60 cm of water for 45 seconds. The plethysmograph records the electrical changes that correspond to changes in the volume of blood in the vein at the time the pressure is exerted and again three seconds after the cuff is deflated. This procedure is repeated several times in both legs. This test takes 30 to 45 minutes. Impedance phlebography is also called an impedance test of blood flow or impedance plethysmography.

Finding out the Results

Your examination will be studied and then the report will be given to your doctor. Then your doctor will discuss the results with you and explain what they mean in relation to your health. Results cannot be given directly to the patient or family