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Moonshine St. 14/05
Light City, London

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00 (123) 456 78 90

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We are a diagnostic imaging provider specializing in vascular ultrasound, committed to delivering accurate results and fostering long-term partnerships with healthcare professionals and patients.

Cerebrovascular / Carotid and Vertebral Artery Assessment Summary

The carotid and vertebral arteries supply oxygen-rich blood to the brain. The right common carotid arises from the brachiocephalic artery, and the left from the aortic arch. Each common carotid splits into the external (supplying head and neck) and internal (supplying brain and eyes) carotid arteries. Vertebral arteries originate from the subclavian arteries and support posterior brain circulation.

Duplex ultrasound, combining B-mode and Doppler imaging, is used to detect stenosis (>50%) or occlusion (100%) in these vessels. These conditions can impair brain perfusion, potentially leading to neurological symptoms or stroke, although some patients may remain asymptomatic due to compensatory circulation.

Common reasons for assessment include: stroke or TIA symptoms, syncope, vertigo, memory issues, vascular disease, neck bruit, and surgical surveillance.

Abdominal Vascular Studies – Arterial and Venous

Arterial Tests:

Includes: Aorto-iliac, renal artery, and visceral vessel assessments.
Purpose: To evaluate blood flow from the aorta to organs such as the kidneys, intestines, groin, buttocks, and legs.

Venous Tests:

Includes: Ilio-caval system, pelvic congestion, ovarian/testicular vein incompetence, Nut-Cracker and May-Thurner syndromes.
Purpose: To assess venous return from abdominal organs and lower limbs to the heart via the inferior vena cava.

Common Indications:

Aorto-iliac: Aneurysms, claudication, rest pain, ulcers, loss of pulses, impotence, spinal/kidney transplant work-up.
Visceral vessels: Post-meal abdominal pain, aneurysms, stent or bypass surveillance.
Renal arteries: Hypertension, kidney dysfunction, transplant or stent follow-up.
Ilio-caval: Bilateral leg swelling, DVT suspicion, haematuria (Nut-Cracker), spinal fusion prep.
Ovarian/Gonadal veins: Varices, pelvic pain, pelvic congestion symptoms, bladder/bowel irritation.

Lower Limb Vascular Assessment – Venous and Arterial

Venous Studies:

Evaluate the deep and superficial venous systems for efficient blood return to the heart.
Effective function relies on: calf muscle pump, valve competence, and unobstructed veins.
Dysfunction can cause limb pain or swelling.
Vascular ultrasound is the most accurate method for assessment.

Arterial Studies:

Assess blood flow and structural integrity of arteries in the legs.
Symptoms may not always correlate with ultrasound findings—may require further testing (e.g., abdominal vessel imaging, ABI/TBI).
Also used for aneurysm screening and bypass graft monitoring to improve limb salvage outcomes.

Common Indications:

Venous Incompetence: Varicose veins, leg swelling, ulcers, skin discoloration, Klippel-Trenaunay Syndrome.
Venous Thrombosis: Suspected/follow-up DVT or SVT, swelling, limb pain, stroke risk from embolism.
Arterial Disease: Claudication, aneurysms, ulcers, PVD, graft/stent checks, pulse loss, foot discoloration, Raynaud’s, Buerger’s Disease.

Upper Limb Vascular Assessment – Venous and Arterial

Venous Studies:

Deep veins: brachiocephalic, subclavian, axillary, brachial, radial, and ulnar (associated with DVT; have paired arteries).
Superficial veins: cephalic, basilic, median antecubital (associated with SVT; no paired arteries).
Deep veins are responsible for most venous drainage into the superior vena cava (SVC) and then the heart.
Superficial veins drain into deep veins via venous confluences.

Arterial Studies:

Includes: subclavian, axillary, brachial, radial, and ulnar arteries.
Right side: subclavian arises from the brachiocephalic artery.
Left side: subclavian arises directly from the aorta.
Blood is delivered to the hand and fingers via radial and ulnar arteries and microvasculature.

Common Indications:

Venous: DVT/SVT screening, arm swelling or pain, Paget-Schroetter Syndrome, venous Thoracic Outlet Syndrome (vTOS), dialysis fistula (AVF).
Arterial: Hand numbness or ischemia, pulse loss with arm elevation, blood pressure differences, subclavian steal syndrome, Raynaud’s Disease, arterial TOS (aTOS), AVF assessment, graft/stent surveillance.

Abdominal Vascular Studies – Arterial and Venous

These tests complement duplex ultrasound and are part of standard vascular assessment protocols for suspected or known arterial disease.

    • Compares blood pressure in the brachial artery to the posterior tibial and dorsalis pedis arteries at the ankle.
    • Can be done at rest or after exercise:

Resting ABI: Assesses vascular disease and post-treatment perfusion.
Exercise ABI: Identifies disease impact under stress (e.g., walking); useful for atypical leg pain with possible spinal origin.

  • Compares brachial artery pressure to great toe pressure using a small cuff.
  • Used when ankle arteries are
    calcified or incompressible.
  • Helps assess severity of disease, healing potential of foot/toe ulcers, and microvascular disease, especially in diabetics.
  • Compares brachial pressure to finger pressure.
  • Evaluates hand ischemia due to arterial stenosis/occlusion.
  • Used for patients with arterio-venous fistulas (AVF), where blood diversion may cause hand symptoms (e.g., cramps, tingling).

Lower Limb Wound/Ulceration Assessment

Ulcers on the lower leg are commonly classified as venous, arterial, or mixed in origin. Their location and appearance provide key clues to the underlying cause:

Foot ulcers → Often linked to arterial insufficiency
Ulcers between knee and ankle → Often due to venous insufficiency
Mixed ulcers → Combine both arterial and venous components

Duplex Doppler ultrasound is an effective tool to differentiate ulcer types and guide appropriate treatment.

Common Diagnostic Tests:

Lower Limb Arterial Duplex: Checks for arterial blockages affecting wound healing.
Lower Limb Venous Duplex: Assesses for venous reflux or pooling.
Toe-Brachial Index (TBI): Measures foot perfusion and helps determine if compression therapy is appropriate or contraindicated.
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