Vascular Imaging

Our state-of-the-art vascular laboratory offers the full spectrum of non-invasive diagnostic modalities for the detection of vascular disease. We perform physiologic testing for peripheral arterial disease (PAD) including measurement of the ankle-brachial index (ABI) with segmental pressures/pulse volume recordings and exercise treadmill testing. In addition, we perform arterial duplex ultrasonography of the carotid arteries, lower-, and upper-extremity arter­ies, the aorta and renal arteries, as well as venous ultrasonography of the upper and lower extremi­ties. 

Our lab is accredited by the Intersocietal Accreditation Commission for Vascular Testing, which means that the lab meets the highest stan­dards of quality patient care and monitoring.

One of our fastest growing services, our lab performs over 1,800 vascular studies annually.

What is the purpose or benefit of vascular imaging? 

Vascular Disease is the term given to disorders of the blood vessels in the body that interfere with the normal flow of blood. Two of the main types of vascular disease are aneurysmaldisease and obstructivedisease. 

In aneurysmal vascular disease, the wall of a weakened blood vessel balloons out. This can lead to the formation of blood clots, especially in the legs, or even rupture. Obstructive vascular disease is the disruption of the normal flow of blood through the blood vessels usually as a result of atherosclerosis, the accumulation of fatty plaque in the walls of arteries. Patients with atherosclerosis are at increased risk for stroke and heart attack. 

Coronary artery disease occurs when atherosclerosis blocks the arteries that carry blood to the heart. However, atherosclerosis can occur in anyof the blood vessels in the body. In fact, a significant number of patients with coronary artery disease also suffer from peripheral artery disease (PAD)—narrowing of arteries that carry blood to other parts of the body, such as the kidneys, the legs, or the arms; or carotid artery disease—narrowing of the carotid arteries, which carry blood to the brain. 

Some common symptoms of PAD include a painful muscle cramping in the hips, thighs or calves when walking, climbing stairs or exercising. Often patients dismiss leg pain as a normal sign of aging, which may contribute to why PAD is one of the most underdiagnosed and undertreated conditions. A key indicator is that PAD pain occurs in the muscles, not the joints. 

The Vascular Medicine Service at Weill Cornell Cardiology provides diagnostic and treatment options to our heart patients with carotid artery disease and peripheral vascular disease. 

The vascular diagnostic laboratory offers a number of non-invasive tests, including

Measurement of the Ankle-Brachial Index with Pulse volume recordings

This painless, non-invasive method is often used as the initial screening for peripheral arterial disease. Using standard blood pressure cuffs and a special stethoscope, blood pressure is measured in the arms and legs to determine how well blood flows through the vessels.

A treadmill exercise test may also be performed. During this test, the patient walks on a treadmill until a symptom appears. Once this happens, the blood pressures are measured again. This test is useful to determine the severity of the blockages in the leg arteries and may also be used to differentiate symptoms of vascular disease from other causes of leg pain.

Vascular Ultrasound Testing

This noninvasive procedure uses ultrasound to produce images of a blood vessel and to provide information on the speed with which blood travels through the vessel. Weill Cornell offers the most advanced ultrasound testing for vascular disease, including: 

• Arterial duplex imaging for detecting abdominal aortic aneurysms as well as narrowing of the carotid arteries, renal arteries, and arteries of the arms and legs. 
• Graft surveillance for those patients who have been treated for peripheral arterial disease with a graft or stent. Ultrasound evaluation of the treated area is part of the follow-up procedure. This is done to ensure that the graft remains unblocked and to try to identify any potential problems before they occur. 
• Venous duplex imaging to detect blockages/blood clots in the veins of the legs. 

Angiograms for further evaluation

If obstructive vascular disease has been identified with these non-invasive tests, your physician may recommend an angiogram. An angiogram is an invasive test that is performed in the cardiac catheterization laboratory. A thin tube, called a catheter, is inserted into the groin and is led to the affected site. A dye is then introduced through the tube to allow the blockage to be visualized and evaluated prior to treatment.

Read more information on treatment for PAD.