Vascular screenings - taking a peek at problem plumbing

These accurate, quick and painless tests can provide vital information, potentially alerting you and your physician to life-threatening conditions. However, Medicare and most insurance companies do not cover the cost of the screening exams. You can pay cash for the tests at various sites, and many hospitals and clinics offer free screenings throughout the year on a first-come, first-serve basis.

Four national organizations - the Society of Vascular Surgery, Society for Vascular Medicine and Biology, the American Vascular Association and the U.S. Preventive Services Task Force - all agree that screenings can be a good thing if they are:

• Performed by qualified medical personnel

• Read by physicians who are professionally trained in this area

• And offered at an accredited site that performs regular quality assurance (a simple phone call to the screening site can help you know whether these criteria are being met)

Screening Guidelines

The national organizations established common guidelines for those who would benefit most from cardiovascular screenings. Patients who are at highest risk for vascular disease and who are the best candidates for vascular screening are men and women over the age of 60 with the following medical conditions:

• Hypertension 

• Coronary artery disease

• Smoking 

• Diabetes 

• Any other form of arterial disease, such as claudication or erectile dysfunction

In addition, patients with any form of arterial disease or family history of abdominal aortic aneurysm or stroke are at the highest risk for cardiac and vascular disease. A thorough vascular screening is most beneficial for these patients.

Screenings - The Big Three

The three most popular vascular screenings detect abnormalities in the carotid artery, the peripheral arterial system, and enlargements of the abdominal aortic artery.

Blockages, or "plaques," in the carotid arteries can impair the blood flow to the brain, leading to stroke. An ultrasound test can quickly and painlessly detect any plaques within these vessels. An ultrasound probe and gel are placed on the neck vessels and images are obtained instantly. A formal carotid ultrasound is usually recommended if abnormalities are found during the screening.

Peripheral arterial disease screening is done with blood pressure cuffs placed around the arms and ankles. A small ultrasound probe is place over the artery and pressures are measured at each cuff. If the pressure is less in the legs as compared to the arms, there may be blockages within the peripheral arterial system and an increased chance of coronary artery disease.

An abdominal aortic aneurysm screen is performed with an ultrasound probe placed on the abdomen to visualize the aorta. Images and measurements of the aortic artery are recorded, and the technologist and physician will instantly know if these measurements are larger than the normal parameters. Further formal testing will be recommended if the test is positive for an aneurysm.

Because aneurysms are usually painless until they become very large, most people with an aneurysm have no symptoms. If an abdominal aortic aneurysm ruptures, it usually is fatal.

Ask Questions

The Society of Vascular Ultrasound has stated concern that there is a lack of standardization with screening exams. Concern is primarily with the qualifications of the technologist doing the screening, the physician interpreting the exam and where screenings are performed.

The Society of Vascular Ultrasound recommends that exams be performed only by physicians or professionals certified in the area of testing being performed. These professionals should have the experience to assure an accurate examination. Screening should be performed in an accredited facility, lab or hospital.

Preventive screening ultrasounds may identify limb and life-threatening problems before they become medical emergencies or lead to debilitating conditions. If you would like more information on these screenings, please call us at (608) 263-7420.

This article was written by Nancy Bell, RN, RVT, with UW Health Preventive Cardiology.