Investigations

• Blood tests and ECG
  For evidence of anaemia, kidney disease, collagen disease or ischaemic heart disease
• Colour Ultrasound Doppler Studies
  A Duplex scanner (ultrasonic) detects an image of blood vessels, and allows Doppler recordings to indicate velocity of flow. Any plaque will be seen.
• Exercise testing (treadmill or step tests)
  The foot pressure normally rises with exercise. In the presence of peripheral arterial disease, however, the foot pressure drops. It enables the claudication distance and the recovery time to be accurately measured. It is very helpful, but in reality, is used less frequently.
• MRI Scanning
  In this context, it is known as Magnetic Resonance Angiography (MRA) scanning
• Fast Computerised Tomography (CT) scanning
  Non- invasive and can detect areas of arterial narrowing accurately; a 3-D picture of the blood vessel can be seen.
• Arteriography or Angiography
  This is the process whereby a special dye is used to visualise arteries. In this case, the dye (which shows up on x-rays), is injected into the femoral artery at the top of the leg. This enables the arteries to be seen, and X-ray images are taken, or the image may be projected onto a TV monitor. Any areas of narrowing (stenosis) or blockage (occlusion) of the vessel will be seen. It is an invasive procedure and usually undertaken if surgery or a procedure (angioplasty) is likely to follow.
• Buerger’s Test (Sign)
  When the person with peripheral vascular disease lies down, and the affected leg is elevated to 45 degrees for about 2 minutes, it becomes demonstrably pale, as the arterial supply cannot overcome the effects of gravity. If the legs are then hung over the edge of the bed, the affected limb first becomes bluish (due to the blood passing through deoxygenated tissues) and then red. This is known as “reactive hyperaemia”.

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• Ankle-Brachial Pressure Index (ABPI)

Amended April 2008