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Vascular screening exams

There are 3 major types of vascular screening exams:

1. Limited abdominal ultrasound for abdominal aortic aneurysm (AAA)

         In this study, the technician will apply an ultrasound probe to your abdomen to evaluate whether you have an AAA.

2. Limited neck ultrasound for carotid stenosis

         In this study, the technician will apply an ultrasound probe to either side of your neck to evaluate whether you have carotid stenosis.

3. Ankle-brachial index (ABI) for peripheral arterial disease (PAD)

         In this study, the technician will place blood pressure cuffs on you arms and ankles to determine if you have PAD. 

A screening exam differs from a formal study in that it is a very limited evaluation. You can think of a screening exam as answering a yes/no question, "Do I have it or not?" It is not intended to answer the question, "How severe is it?" If you have a positive finding on a screening exam, then typically you are advised to undergo a formal imaging study.  

Screening exams are used for vascular disease because many of these diseases are "silent," meaning that people may be unaware they have the problem until they suffer a major event (stroke, ruptured aneurysm, gangrene). Screening exams have also helped to educate the general public about vascular disease. It is a somewhat shocking statistic that more people have PAD than all types of cancer combined, yet 75% of adults in the U.S. don't know what PAD is. 

It is important to realize, however, that it is not wise to screen all people. It is very unlikely that a person under the age of 60 with no risk factors for vascular disease will have positive findings on a screening exam. Similarly, a man who is 70 and has hypertension and has smoked for 40 years and has 3 family members who have all died of ruptured aneurysms should probably have a formal imaging study of his abdomen rather than a screening exam (because if the screening exam was negative, would you really believe it, anyway?). A woman who has had a carotid surgery and gets regular surveillance ultrasound exams with her vascular surgeon does not need a screening carotid study. Also, a person with symptoms of claudication or a non-healing foot wound needs a formal evaluation, not a screening exam.  

Vascular surgeons support selective screening of at-risk populations of people. What does that mean? It means it may be reasonable to consider screening if you are over the age of 60 and have risk factors for atherosclerosis or aneurysm (hypertension, high cholesterol, diabetes, greater than 100 pack smoking history, and/or family history for heart attack, stroke or AAA). It is best to discuss your concerns with you doctor.

Many private companies conduct screening exams for a small fee. They may also offer other types of screening (bone density, rhythm strip for cardiac arrhythmia). These other exams are not vascular exams and are not discussed on this website.

If you opt to have a screening exam, be sure to obtain and review the results of your testing. If there are positive findings on your report, review these with your doctor. 

Our next Vascular Screening Day is Wednesday, February 12, in our 1100 S. Eliseo office. Call 415-464-5400 for details.  
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