Monitoring Your Vascular Health with Comprehensive Screenings

Bradley Mays, M.D., Medical Director of Columbia St. Mary’s Vascular Institute

Posted: Feb. 1, 2008

An estimated 20 to 30 million Americans are at risk for various vascular diseases, including stroke, peripheral arterial disease, carotid artery disease and aortic aneurysms.

New screening tests offered at Columbia St. Mary’s Vascular Institute are key tools in detecting these forms of vascular disease. Our comprehensive vascular screening package includes carotid artery/stroke screening, abdominal aortic aneurysm screening and the Ankle Brachial Index test to diagnose peripheral arterial disease.

Many people with these conditions do not initially experience any symptoms. The screening tests, which are noninvasive and painless, provide your physician with important information for advising appropriate treatments and lifestyle modifications.

Carotid artery/stroke screening
Carotid artery disease (CAD) is the narrowing of the carotid arteries, the main arteries in the neck that supply blood to the brain. CAD is a major risk factor for stroke. A carotid artery/stroke screening involves the ultrasound of the carotid arteries to identify the build-up of fatty plaque that can narrow the arteries and cause a stroke.

Abdominal aortic aneurysm screening
The abdominal aorta supplies blood to the lower part of the body. When the lining in the wall of this blood vessel becomes weakened and expands in size, it is called an abdominal aortic aneurysm (AAA). The pressure from blood flowing through your abdominal aorta can cause a weakened part of the aorta to bulge, much like a balloon. Left untreated, aneurysms can burst or rupture, causing severe internal bleeding, which can lead to shock or even death. Victims of AAA may not initially feel any symptoms. The abdominal aortic aneurysm screening uses an abdominal ultrasound to determine the presence of an enlargement in the abdominal aorta and measure its size. When the aneurysm reaches approximately five centimeters, it is at high risk for rupture and most doctors will recommend surgery.

Ankle Brachial Index (ABI)
The ABI is a test used to diagnose peripheral arterial disease (PAD). Caused by a blockage in the peripheral arteries of the arms, legs or pelvis, PAD can cause pain, changes in skin color, sores or ulcers and difficulty walking. If left untreated, PAD can impair circulation and lead to serious disability or amputation. The ABI test uses a standard blood pressure cuff to get a blood pressure reading from your ankle and your arm. The doctor then compares the two readings. Normally, the ankle pressure is at least 90 percent of the arm pressure, but with severe narrowing it may be less than 50 percent.

If an ABI reveals an abnormal ratio between the blood pressure of the ankle and arm, your doctor may recommend more testing.

Who should be screened for vascular disease?
People over the age of 55 to 60 with certain risk factors are candidates for vascular disease screening. Risk factors may include:

• Diabetes
• High blood pressure
• High cholesterol
• Smoking
• Physical inactivity
• Obesity
• Family history of cardiovascular disease, circulatory problems or stroke

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