• What Is Vascular Screening?
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Abdominal Aortic Aneurysm
Peripheral Artery Disease
|What Is Vascular Screening?
It is a painless test which checks for the buildup of fatty deposits (atherosclerosis) in the arteries of the body. Blood and oxygen is transported around the body by an extensive network of arteries and smaller vessels which together make up the cardiovascular system (or vascular system for short). Any blockages in these arteries can cause sudden and severe illness, even death, depending on where the blockage occurs. Screening the vascular system with ultrasound technology for signs of narrowing or blockages can help prevent future heart attacks, strokes and impaired blood flow to the legs, arms and abdomen. Many medical centers across the United States and Europe offer vascular screening to the general public. Screenings however are not meant to replace diagnostic exams. A 'screening' is where a person is checked for signs of a disease although they show no symptoms. The individual or their doctor may want the test performed due to risk factors, family history or just out of general concern for their health. While screenings can indicate the presence of disease they cannot characterize or quantify the extent. Diagnostic tests are necessary for this; these are exams which are performed out of medical necessity with a physician referral (such as heart disease testing at chest pain clinics).
Screening is open to men and women of all ages with or without known heart disease. It is however most beneficial to:
• The test is painless and does not require undressing or exercising.
Typically a screening will look for signs of the following three conditions:
The screening takes about 40 minutes and involves the use of ultrasound technology (very similar to that used during a pregnancy ultrasound scan). The patient is asked to lie down and to raise their top so that their tummy is revealed. A technician will apply some transparent gel to the area and use a doppler ultrasound to provide internal images of the aorta. This is the abdominal aortic aneurysm scan (AAA). If an aneurysm is present and the area is tender to touch or the diameter is 5.5 cm or more, the risk of rupture is high. This is considered a medical emergency. Next the carotid arteries will be measured for thickness (carotid artery intima-media thickness, CIMT). If the walls are notably thick your risk of heart attack and stroke are significant. To check for PAD a blood pressure cuff is placed on the arms and ankles. As they are inflated to increase pressure a small ultrasound device will be used to measure the systolic pressures in the limbs. If there are no signs of PAD the blood pressure should be roughly equal in both the arms and feet meaning there are no circulation issues. If blood pressure is lower in one area it suggests blood flow restrictions which will need further diagnostic testing.
It may take up to a week to receive your test results (unless it is performed in an emergency situation). The results usually include a comprehensive report detailing how your results compare to others (normal or not). Recommendation on actions to take, if any, will also be made. If signs of disease are noted the center will tell you to report the results to your doctor for recommendation on prevention and treatment strategies.
If your first screening produces no findings, then a screening every 5 years is normally sufficient. If any problems were indicated a yearly exam may prove beneficial.
I'm Only 40. Do I Need To Be Screened?
I Feel Healthy, Should I Test?
No health screening is 100 percent accurate, but they can come fairly close. Generally vascular testing is about 90 percent accurate in detecting atherosclerosis of the arteries. This compares to 80 percent with a stress test combined with echocardiogram (ECG).
Some people choose just to scan one part of the body, for example the aortic arteries in the abdomen or the carotid arteries in the neck. Others choose to test for all 3 areas, which may cost between $250 and $350. Individually tests cost about $90 to $120. Some health insurance companies cover the cost, but only in high risk categories (primarily men after the age of 65 who smoke). Medicare currently only covers a one-time abdominal aortic aneurysm screening as part of their Welcome to Medicare physical - and only for men over 65 with a history of smoking.
Legs For Life is a U.S. national screening program for vascular disease, which promotes the screening for PAD, AAA and carotid disease. Participating practices around the country offer their services free for one week a year (usually in September) to promote awareness, but spaces are limited. To find a free service near you, view their website at: www.legsforlife.org for details. Legs for Life is a community health program founded in 1997 by the Society of Interventional Radiology and is supported by the American Diabetes Association, the American Radiological Nurses Association (ARNA), the Cardiovascular Radiology Council of the American Heart Association and the Society for Vascular Nursing (SVN).
The Legs for Life website, previously mentioned has a list of centers in the US which provide screening. Alternatively you can go to the Society of Interventional Radiology's website at www.sirweb.org. Simply click on their Doctor Finder and scroll down to PAD, AAA or carotid screening. Most centers will offer a combination of all three screenings.
If you are at high risk for cardiovascular disease your chance of heart attack, stroke and circulatory problems increase significantly. Risk factors are:
Age: Early screening is appropriate after the age of 40.
|Related Articles on Screening For Blocked Arteries
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