Vascular Screening
Testing For Signs Of Blocked Arteries

screening for blocked arteries


Stroke Prevention

Carotid Artery Screening
Using Ultrasound Technology

Vascular Screening

Contents

What Is Vascular Screening?
Who Needs It?
What Are The Advantages?
What Does It Screen For?
What Happens During The Test?
What Do The Results Show?
How Often Should I Test?
I Feel Healthy, Should I Test?
How Accurate Is Screening?
How Much Does It Cost?
What Is Legs For Life?
Where Can I Locate A Screening Program?
Who Is Particularly High Risk For Vascular Disease?


Return To Main Guide
Stroke in Women

AAA ScanAbdominal Aortic Aneurysm

Carotid Scan
Carotid Artery Disease

PAD ScanPeripheral 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).

Who Needs It?

Screening is open to men and women of all ages with or without known heart disease. It is however most beneficial to:

• Those with known risk factors for heart disease.
• People with stroke risk factors.
• People over the age 40 with or without risk factors.
• People with long-term high cholesterol or hypertension.
• Those with diabetes or who smoke – both categories are more prone to cardiac problems.
• It may be used in an emergency situation for stroke diagnosis.

What Are The Advantages?

• The test is painless and does not require undressing or exercising.
• It is not invasive so no blood needs to be drawn.
• It can detect signs of atherosclerosis sooner than a standard exercise stress test.
• By identifying early signs of disease it gives patient the chance to implement prevention strategies to slow down or halt the progression of disease.
• It helps to identify existing vascular disease which can then be treated before it causes a life-threatening event.

What Does It Screen For?

Typically a screening will look for signs of the following three conditions:

Carotid Artery Disease
The carotid arteries are the 2 large arteries which supply blood to the brain. They are located on each side of the neck. Over time atherosclerosis can form in these arteries causing narrowing and blockages. If blood becomes completely blocked it can cause a stroke. Usually the disease does not cause any symptoms so the first sign of a problem could be a stroke.

Peripheral Artery Disease (PAD)
PAD is narrowing of the peripheral arteries - that is the blood vessels (legs, arms and head) which are farthest from the heart. Blockages in these arteries can cause limb numbness, pain and open sores. If it is severe enough it can result in gangrene and amputation. People with coronary heart disease (CHD) have a 1 in 3 chance of developing blocked arteries in the legs.

Abdominal Aortic Aneurysm
The aorta is the largest blood vessel in the body which leads from the heart down into the abdomen where it then branches into two smaller arteries to supply the legs. An abdominal aortic aneurysm is when the part of the aorta in the abdominal region swells and has the potential to burst causing heavy internal bleeding and sudden death. Up to 75 percent of people with a ruptured aorta will die before they reach hospital. It is more common in white men over the age of 60 than women; and in those with symptoms of CHD and PAD. Screening is recommended for people with risk factors. Note: It is not related to aneurysms of the brain.

What Happens During The Test?

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.

What Do The Results Show?

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.

How Often Should I Test?

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?

The risk of cardiovascular disease increases with age, particularly after the age of 40. Many of the diseases associated with the vascular system are 'silent' (meaning they do not cause warning signs) but they are deadly. For this reason everyone after the age of 40 should consider testing.

I Feel Healthy, Should I Test?

As cardiovascular diseases are silent, you may feel healthy, even when they are quite progressed. Very often the first sign is a stroke or a heart attack. Additionally, vascular screening is not only useful for detecting disease, but it can also detect early signs of disease which may be missed during an exercise stress test. This gives you the chance to implement prevention strategies such as following a healthier diet and exercising to prevent further deterioration. In summary, no matter what your health condition, you will benefit from screening after 40.

How Accurate Is Screening?

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).

How Much Does It Cost?

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.

What Is Legs For Life?

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).

Where Can I Locate A Screening Program?

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.

Who Is Particularly High Risk For Vascular Disease?

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.
Family History: If a close family member died of a heart attack or stroke before the age of 65.
Smoking: Smokers are nearly 3 times more likely to suffer heart attacks.
High Cholesterol: Long-term high cholesterol levels increase your risk factors. Your aim should be to keep LDL levels below 5.0 and LDL below 3.0.
Obesity: If your waist circumference is above 88cm (women) and 100cm (men) and/or your body mass index (BMI) is above 25.
Diabetes: Diabetics are at increased risk of stroke and heart attack. Control of blood sugar levels is an important element in coronary heart disease prevention and stroke prevention.
Previous History: If you have already had a cardiac event, you are at increased risk of another.

  Related Articles on Screening For Blocked Arteries

For more conditions, see the following:

Causes of Stroke
Ischemic Stroke / Mini Stroke
Symptoms of Stroke
Effects of Stroke / Stroke Treatment

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