Ultrasound Scan:
Leg Arterial Doppler

Leg arterial disease, also known as peripheral artery disease (PAD), refers to the narrowing or blockage of arteries that supply blood to the legs and feet. It is a common circulatory problem that occurs when plaque buildup (atherosclerosis) restricts blood flow to the lower extremities.

 

The primary cause of leg arterial disease is atherosclerosis, which is the gradual buildup of fatty deposits, cholesterol, calcium, and other substances within the arterial walls. Over time, these deposits form plaques, narrowing the arteries and impeding the smooth flow of blood. Reduced blood flow to the legs can lead to various symptoms and complications.

This scan usually takes between 20 minutes to complete for a single leg and 30 minutes for both legs.

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The purpose of this ultrasound is to assess the blood flow to your feet. This ultrasound requires direct contact with your skin. The scan starts at the groin crease and the entire leg is scanned down to the ankles. We will require you to remove your shoes, socks, trousers/shorts and we will provide you with a disposable gown. Dresses and skirts don't need to be removed and can be lifted out of the way.

We will ask for you to lie on your back on our examination bed. During the scan we will apply ultrasound gel to your legs and use the ultrasound machine to look at the the arteries and assess for narrowing and blockages. You will hear noises from the ultrasound machine; this is all normal and is the sound of the blood flow moving through your arteries.

Leg artery scans are non-invasive, painless, and provide real-time imaging of the leg arteries. Leg artery scans, also known as lower extremity arterial Doppler ultrasound or lower limb arterial duplex, are performed to assess the blood flow and detect any abnormalities in the arteries of the legs. The most common type of narrowing or occlusion is caused by either atherosclerosis (plaque) or thrombus. The arteries assessed include the common femoral artery, profunda femoris artery, superficial femoral artery, popliteal artery, tibioperoneal trunk, posterior tibial arteries, peroneal arteries, and anterior tibial arteries. The main reasons why leg artery ultrasound scans are done:

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Diagnosing peripheral artery disease (PAD)

Leg artery scans are commonly performed to diagnose peripheral artery disease, which is the narrowing or blockage of arteries in the legs. The ultrasound helps evaluate the blood flow, identify areas of stenosis (narrowing), or detect complete blockages in the leg arteries.

 

Assessing the severity and location of arterial blockages

Leg artery scans provide detailed imaging of the leg arteries, allowing healthcare professionals to assess the severity and location of arterial blockages. This information helps determine the appropriate treatment approach, such as lifestyle modifications, medications, or interventional procedures like angioplasty or bypass surgery.

 

Evaluating arterial function and blood flow dynamics

Leg artery scans can assess the functionality and response of the leg arteries to various stimuli, such as exercise or medication. This information helps determine the efficiency of blood flow and provides insights into the extent of arterial disease and its impact on leg function.

 

Monitoring disease progression

For individuals with known peripheral artery disease, regular leg artery scans can be performed to monitor the progression of the disease over time. These scans help healthcare providers assess the effectiveness of treatments, adjust medications or interventions, and track any changes in the leg arteries.

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Planning for interventions or surgeries

Leg artery scans are often performed as part of the preoperative planning process for interventions or surgeries, such as angioplasty, stenting, or bypass surgery. The ultrasound provides critical information about the location and severity of arterial blockages, helping guide the treatment strategy.

Leg arterial disease, also known as peripheral artery disease (PAD) affecting the lower extremities, is influenced by several risk factors that increase the likelihood of developing the condition. These risk factors can be categorised into modifiable and non-modifiable factors.

 

Age

The risk of developing leg arterial disease increases with age, particularly in individuals over 50 years old.

 

Smoking

Tobacco smoking is one of the most significant risk factors for leg arterial disease. Smoking damages blood vessels, promotes inflammation, and accelerates the development of atherosclerosis, which narrows and blocks the arteries.

 

Diabetes

Individuals with diabetes have an increased risk of developing leg arterial disease. Diabetes can damage blood vessels and impair blood flow, increasing the risk of atherosclerosis and peripheral artery disease.

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High blood pressure

Hypertension, or high blood pressure, is a risk factor for leg arterial disease. High blood pressure damages the arterial walls, making them more susceptible to plaque buildup and narrowing.

 

High cholesterol levels

Elevated levels of LDL cholesterol (often referred to as "bad" cholesterol) and reduced levels of HDL cholesterol (often referred to as "good" cholesterol) are associated with an increased risk of leg arterial disease. High cholesterol contributes to the formation of plaque within the arteries.

 

Obesity

Excess body weight, particularly central obesity (abdominal fat), is associated with an increased risk of leg arterial disease. Obesity is often accompanied by other risk factors such as high blood pressure, high cholesterol, and diabetes.

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Sedentary lifestyle

Lack of regular physical activity and a sedentary lifestyle contribute to the development of leg arterial disease. Regular exercise promotes cardiovascular health, improves blood flow, and helps control other risk factors.

 

Family history

Having a family history of peripheral artery disease or cardiovascular disease increases the risk of developing leg arterial disease. This suggests a genetic predisposition to the condition.

 

Ethnicity

Certain ethnic groups, such as African Americans, have a higher prevalence of leg arterial disease compared to other populations.

Lower limb arterial disease can be cause by a number of factors

 

Other medical conditions

Conditions such as chronic kidney disease, autoimmune disorders, and a history of cardiovascular diseases (such as heart disease or stroke) increase the risk of leg arterial disease.

 

It's important to note that while these risk factors contribute to the development of leg arterial disease, their presence does not necessarily mean that an individual will develop the condition. Adopting a healthy lifestyle, managing modifiable risk factors, and working closely with healthcare professionals can help reduce the risk of leg arterial disease and related complications.

Leg arterial disease, also known as peripheral artery disease (PAD), occurs due to the narrowing or blockage of arteries that supply blood to the legs. The symptoms of leg arterial disease can vary depending on the severity of the condition. Here are some common symptoms associated with leg arterial disease:

 

Claudication

Claudication is the hallmark symptom of leg arterial disease. It is characterised by pain, cramping, or aching in the legs, typically in the calves, thighs, or buttocks, during physical activity such as walking or exercising. The pain typically subsides with rest and reoccurs upon resuming activity.

 

Leg fatigue or heaviness

People with leg arterial disease may experience a feeling of fatigue, heaviness, or weakness in the legs, especially during or after physical activity.

 

Coldness

The affected leg or foot may feel cold to the touch compared to the other leg. This occurs due to reduced blood flow to the extremities.

 

Numbness or tingling

Some individuals may experience numbness, tingling, or a "pins and needles" sensation in the legs or feet due to compromised blood flow.

 

Weak or absent pulses

Healthcare providers may detect weak or absent pulses in the legs or feet during a physical examination. This can indicate reduced blood flow to the extremities.

 

Slow wound healing

Leg arterial disease can impair the healing process of wounds, ulcers, or sores on the legs or feet. In severe cases, non-healing wounds or the development of gangrene may occur.

 

Skin changes

The skin on the legs or feet may appear pale, shiny, thin, or have a bluish or reddish hue. Hair loss on the legs or feet and brittle toenails can also be observed.

 

Poor nail growth

Slowed or poor nail growth on the toes may be a sign of reduced blood flow.

 

Rest Pain

Rest pain, also known as ischemic rest pain, is a symptom experienced by individuals with advanced peripheral artery disease (PAD) or severe arterial insufficiency. It refers to pain or discomfort that occurs in the lower extremities, particularly the feet and toes, during periods of rest or inactivity.

Rest pain is typically described as a deep, intense, burning, or throbbing pain that persists even when the legs are at rest, such as when lying down or sitting. The pain can be severe and may worsen at night, disrupting sleep. Movement or dangling the legs over the edge of the bed may temporarily relieve the pain.

 

Ulcers

Arterial ulcers often found on the feet and toes are slow-healing wounds that tend to be resistant to conventional wound treatments.

 

Gangrene

Gangrene is a serious and potentially life-threatening condition characterised by the death and decay of body tissues due to a lack of blood supply or infection. It typically occurs when blood flow to an area is severely restricted or completely blocked, leading to tissue death.

 

It's important to note that some individuals with leg arterial disease may be asymptomatic, especially in the early stages. However, it is crucial to be aware of any symptoms and seek medical evaluation, particularly if you have risk factors such as smoking, diabetes, high blood pressure, or a history of heart disease. Prompt diagnosis and treatment of leg arterial disease can help prevent complications and improve overall leg function and quality of life.

Treatment options for leg arterial disease aim to improve blood flow, manage symptoms, and reduce the risk of complications. The specific treatment approach depends on the severity of the disease, the presence of symptoms, and individual patient considerations. Treatment options for leg arterial disease may include:

 

Lifestyle modifications

Making certain lifestyle changes can help improve symptoms and slow down the progression of leg arterial disease. These may include:

• Smoking cessation: Quitting smoking is crucial as it significantly worsens the disease progression.

• Regular exercise: Engaging in supervised exercise programs or walking regimens can improve walking distance and overall circulation.

• Healthy diet: Adopting a balanced diet low in saturated fats, cholesterol, and sodium can help control weight and manage other cardiovascular risk factors.

• Weight management: Maintaining a healthy weight reduces the burden on the arteries and improves circulation.

• Blood sugar control: For individuals with diabetes, managing blood sugar levels is important to minimize further damage to blood vessels.

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Medications

• Antiplatelet drugs: Medications such as aspirin or clopidogrel are often prescribed to reduce the risk of blood clots and prevent complications.

• Statins: These medications help lower cholesterol levels and stabilize plaque, slowing down the progression of arterial disease.

• Blood pressure-lowering medications: Controlling high blood pressure is essential in managing leg arterial disease and reducing the risk of complications.

 

Revascularisation procedures

• Angioplasty and stenting: In this minimally invasive procedure, a catheter is used to insert a balloon to open the narrowed artery, and a stent may be placed to keep the artery open.

• Bypass surgery: In cases of severe blockages, bypass surgery may be performed to create a new pathway for blood to flow around the blocked segment of the artery.