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In a limb with a normal circulation the toes and sole of the foot, stay pink, even when the limb is raised by 90 degrees. In an ischaemic leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause pallor. (This part of the test checks for elevation pallor.) A vascular angle of less than 20 degrees indicates severe ischaemia. [1] [2]
An ABPI between and including 0.90 and 1.29 considered normal (free from significant PAD), while a lesser than 0.9 indicates arterial disease. [14] An ABPI value of 1.3 or greater is also considered abnormal, and suggests calcification of the walls of the arteries and incompressible vessels, reflecting severe peripheral vascular disease.
The reversed blood pools in the low third of legs and feet. [17] Unlike in the arterial ultrasound study, when the sonographer studies venous insufficiency, the vein wall itself has no relevance and attention is focused on the direction of blood flow. The objective of the examination is to see how the veins drain.
In normal patients, the feet quickly turn pink. If, more slowly, they turn red like a cooked lobster, suspect ischemia. Brodie-Trendelenburg test (assessment of valvular competence if varicose veins are present): One leg at a time. With the patient supine, empty the superficial veins by 'milking' the leg in the distal to proximal direction.
Peripheral arterial disease is more common in these populations: [42] [50] All people who have leg symptoms with exertion (suggestive of claudication) or ischemic rest pain; All people aged 65 years and over, regardless of risk factor status; All people between 50 and 69 who have a cardiovascular risk factor (particularly diabetes or smoking)
Unlike arterial ultrasonography, venous ultrasonography is carried out with the probe in a transversal position, (perpendicular to the vein axis), displaying cross-sections of the veins. [4] All collateral veins are better detected this way, including perforator veins , but of most importance is the detection of venous thrombosis .
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The arterial resistivity index (also called as Resistance index, abbreviated as RI), developed by Léandre Pourcelot , is a measure of pulsatile blood flow that reflects the resistance to blood flow caused by microvascular bed distal to the site of measurement. It is primarily used in ultrasound imaging to evaluate arteries and solid organ damage.