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FAQ-Vascular Scan

What is Vascular Scan?
A vascular study or ultrasound is a non-invasive procedure to assess the blood flow in arteries and veins throughout the body. It uses sound waves to produce pictures that look at the structure and function of the vessels.
A transducer or ultrasound probe is held and moved against your skin, at certain locations and angles, with special ultrasound gel needed for good transmission of the sound waves.
The ultrasound waves move through the skin and other body tissues to the blood vessels, where the waves echo off of the blood cells. The transducer picks up the reflected waves and sends them to an amplifier, which makes the ultrasonic sound waves audible. The test is safe and painless.
Vascular studies can use one of these special types of ultrasound technology, as listed below:
·         Doppler ultrasound - is used to measure and assess the flow of blood through the vessels. It can detect abnormal blood flow within a vessel, which can indicate a blockage.
·         Color Doppler - is an enhanced form of Doppler ultrasound technology. With color Doppler, different colors are used to designate the direction of the blood flow.
What should I do before the procedure?
For the tests involving the abdomen (renal arteries, abdominal aorta, ovarian veins, digestive arteries…), you should fast for at least 8 hours before the scan (no breakfast for morning appointments and light breakfast and no lunch for afternoon appointments). It helps to remove any excess bowel gas which may otherwise restrict the view.
We will need to be notified if you suffer from non-insulin dependant diabetes, as we will try and accommodate you with an early morning appointment. Diabetics using insulin should not fast. Unless specified, you should take your usual medications with a small amount of water.  
For the ovarian veins study, women should be in the second part of their menstrual cycle (close to their periods), because the veins are then larger and easier to visualize.
  • Otherwise, no specific preparation is required for the other ultrasound scans.
  • Before the test, you will be also asked to refrain from smoking as it may create a constriction of your arteries.
  • Prior to the test, you will be required to fill a medical questionnaire, which will help the doctor in his report.   
 Arterial duplex study: scanning the carotid arteries
Why is the test required?
Carotid duplex ultrasound scanning is the main investigation for the detection of plaque which may cause narrowing in the arteries that supply blood to the brain, and may lead to strokes or mini-strokes.
Additionally they are frequently performed for follow-up after surgery (endarterectomy) or stenting of the carotid arteries.
How is the study performed?
You will be lying down, with the neck exposed. You won’t need to undress. Ultrasound gel will be put on your neck and the sonographer will examine the carotid arteries to determine the presence of any plaque and narrowing. During the study you will experience some minor pushing and pressure on your neck, and you will need to tilt your head from side to side. The scan takes about 45 min and is painless and non invasive.
 What are What are the symptoms and why is the test required? 
Symptoms of leg arterial disease may include a cramp-like pain on walking. The pain can get so intense that it may be necessary to stop and rest. This pain can occur in the calves, thigh, buttocks or hips. The symptoms can also include cold feet, pain at rest or feet and leg ulcers. This test will be required if you have these symptoms. It will check for the presence of atheromatous plaque and narrowing. It will also look for aneurysm. The test can also be required to review your arteries after you had an angioplasty or a bypass. The study starts from the femoral arteries and includes popliteal and calf arteries. Depending on the findings, it may be necessary to also scan your abdomen to visualize the aorta and iliac arteries.
How is the study performed?   
You will need to remove you trousers or skirt. You will lie down on the couch and gel will be put on your leg/legs, while the sonographer scans the area of interest. The test takes about 30min per leg and is painless and non invasive. At the end of the study, a pressure calf will be applied to your ankles and arms to measure the blood flow.
Why is the test required?   
This study is commonly performed to assess exercise-induced leg pain (claudication), suspicion of reduced pulses in the lower extremities.  
It is also done in case of suspicion of aneurysm or to follow up the size and location of an aneurysm. 
It can assess the results of balloon angioplasty or stenting of the iliac arteries and following some iliac artery bypass operations, or aneurysm surgery. 
It can also be used to review some previous anomalies. 
The test will check for the presence of atheromatous plaque and narrowing, and aneurysm. Accurate measurements are made of the size of the arteries and blood flow velocities.
How is the study performed?  
You will need to remove you trousers or skirt. You will lie down on the couch and gel will be put on your leg/legs, while the sonographer scans the area of interest. The test takes about 30min per leg and is painless and non invasive. At the end of the study, a pressure calf will be applied to your ankles and arms to measure the blood flow.
Why is the test required?   
This study will examine the arteries that branch off the abdominal aorta to supply the kidneys with blood. These arteries can become narrowed (stenosed) or abnormally dilated (aneurysm). Narrowing can cause loss of renal function or high blood pressure.
How is the study performed?  
For the study, you will need to remove your shirt. You will lie down on the couch and cold gel will be put on your abdomen, while the sonographer scans the area of interest. The scan takes about one hour and is painless and non invasive.
Why is the test required?  
This study will assess the arterial circulation in the upper limbs. If the arteries become narrowed, you can experience some pain in your hands. This test is also done prior to creating an arterio-venous fistula for dialysis purposes.
How is the study performed?  
For the study, you will need to remove your shirt. You will lie down on the couch and cold gel will be put on your arm/arms, while the sonographer scans the area of interest. The scan takes about 45min and is painless and non invasive.
Why is the test required?  
The aim of the study is to examine the arteries that branch off the abdominal aorta to supply blood to the stomach, intestines, colon, liver and spleen. These arteries can become narrowed (stenosed) or abnormally dilated (aneurysm). Narrowing can cause a critical reduction in blood supply to these organs and can cause severe pain while aneurysms can enlarge and bleed.
How is the study performed?  
For the study, you will need to remove your shirt and/or pants. You will lie down on the couch and cold gel will be put on your abdomen, while the sonographer scans the area of interest. The scan takes about 45 min and is painless and non invasive.
Why is the test required ?   
This test is done to map the superficial veins in your legs to assess the origin of varicose veins. The deep veins will also be studied to make sure you had no previous deep vein thrombosis. This study will help the vascular surgeon in his decision making.
How is the study performed?  
For the study, you will need to remove your trousers or skirt. You will lie down on the couch for the first part of the study and then will have to stand up for the second part, to allow your veins to get larger and more visible. Cold gel will be put on your leg/legs, while the sonographer scans the area of interest. The sonographer will be required to squeeze your calf regularly to check the blood flow in your veins. The scan takes about 45 min to 1 hour and is painless and non invasive. The standing up position can be uncomfortable and you may feel dizzy. In that case you will lie on the couch to ease the symptoms.
Why is the test required and what are the symptoms ?  
Symptoms of deep vein thrombosis can include swelling and pain in your ankle or legs. It can occur (but it is not limited) after surgery, if you have been lying still for a long period of time, or if you had a previous thrombosis. This test will study both deep and superficial veins in your legs to exclude the presence of thrombosis (blood clot). The main abdominal veins will also need to be visualized.
How is the study performed?  
For the study, you will need to remove you trousers or skirt. You will lie down on the couch for the first part of the study and then will have to sit up, your feet resting on a step. Cold gel will be put on your leg/legs and abdomen while the sonographer scans the area of interest. The sonographer will be required to squeeze your calf or press the probe onto your legs to assess the patency of the veins. The scan takes about 45 min and is non invasive.
Arterial d   Upper limbs deep veins duplex study
Why is the test required ?
This test can be required to check the presence of deep vein thrombosis in your arm/arms. The symptoms of thrombosis include arm and hand swelling and pain.
How is the study performed?  
For the study, you will need to remove your shirt. You will lie down on the couch and cold gel will be put on your arm/arms, while the sonographer scans the area of interest. The scan takes about 45min and is painless and non invasive.
Why is the test required?   
Prior to an arterial bypass graft, your surgeon may need to know if your veins are suitable to use as a conduit in the bypass surgery (usually superficial veins in your legs).
How is the study performed?   
You will need to remove your pants or skirt and you will need to stand up, to help distend your veins. The technician will apply some gel on your leg(s) and hold the ultrasound probe against your skin to check your veins. The test takes approximately half an hour per leg.
Why is the test required?   
This test is required to assist the surgeon in some varicose veins surgery. It is usually done in the morning before the surgery or the day before.
How is the study performed?   
You will need to remove your pants or skirt and you will usually need to stand up, to help distend your veins. The technician will apply some gel on your leg(s) and hold the ultrasound probe against your skin to identify the veins that need to be marked. When veins are identified, the overlying skin will be marked will a special pen. It is important that these marks are not washed off prior to surgery. The test will take 45min to an hour, depending how many varicose veins need to be marked.
Arterial d   Ovarian veins study
Why is the test required ?    
Ovarian veins can have faulty valves and contribute to varicose veins in the legs or give pelvic symptoms. This test will assess if the ovarian veins are normal or faulty (incompetent), and will help determine the vascular surgeon in his decision making (ligation of the ovarian vein?).
How is the study performed?   
For the study, you will need to remove your shirt. You will lie down on the couch and cold gel will be put on your abdomen, while the sonographer scans the area of interest. The scan takes about one hour and is painless and non invasive.
Arterial d   Ankle to Brachial index (ABI)
Why is the test required ?    
This test is used as a simple screening test for peripheral vascular disease. Peripheral arterial disease can be suspected in a number of cases: leg pain while walking, diminished or absent pulses in the legs. It will compare the blood pressure obtained with a handheld Doppler in the ankle arteries with the blood pressure in the higher of the two brachial pressures. Most of the time, this test will be done after scanning the arteries of your legs or the iliac arteries.
How is the study performed?   
For the study, you will need to remove you trousers or skirt, and will lie down on the couch. A pressure cuff and a handheld Doppler will be applied on your ankles and arms to measure the blood pressure. The test takes about 15mins and is painless and non invasive.
Why is the test required ?    
Before creating an arterio-venous fistula, the arteries and superficial and deep veins of the arm need to be assessed. It is necessary to know if the veins are large enough and if the arteries are normal before an arterio-venous fistula can be done. This test is also required to review the patency of an existing arterio-venous fistula, if there is suspicion of dysfunction (dialysis becoming difficult…)
How is the study performed?   
You will lie on the couch with your arm(s) exposed up to your shoulder. Cold gel will be put on your arm(s), while the sonographer scans the area of interest. At some point during the test the sonographer will be required to put an elastic band on your arm so the veins are easier to visualize. The scan takes about 45mins and is painless and non invasive.

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