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Vascular Studies Unit

9Description of service

The Vascular Studies Unit carries out tests to check your circulation (arteries and/or veins).

These tests use ultrasound to measure blood flow in the major blood vessels of your circulation. The ultrasound scan can identify precisely where blockages (or areas of narrowing) are located and how much of a blockage (or narrowing) there is.

Because our ultrasound scans do two things (take pictures AND measure blood flow) they are often called "Duplex" scans.

The tests are carried out by a Clinical Vascular Scientist in one of our examination rooms using specialist ultrasound equipment. Depending on your symptoms these tests may be on your stomach, legs, feet, arms, or your neck.

Our ultrasound scans are safe, non-invasive (that means no injections) and the only thing you feel is the pressure of the probe on your skin. No special preparation is required prior to the scan (you can eat, drink and take your tablets as normal) and there are no side-effects after. If you wear a hearing-aid or have a pacemaker these will not be affected by the ultrasound scan.

The tests usually involve lying or sitting on a comfortable examination couch in a examination room. The ultrasound probe is placed on the surface of your skin (using some water-based gel for good contact) and gently moved over the area of interest. The ultrasound scan is an 'open' scan and does not put you through a tunnel or enclose you in a tight space. In fact many patients find the experience quite relaxing.

The Clinical Vascular Scientist will be able to advise you of the results immediately and answer any questions you may have regarding the test and the results.

Here are the principal tests that we carry out:

Checking the ARTERIAL circulation to your head and brain

This is called a "Carotid Duplex Scan" and is an ultrasound scan of the main arteries in the neck.

Why have you been referred for this test? Your doctor (GP or hospital doctor) suspects you may have had a stroke or a mini-stroke. Perhaps you have experienced one of the following symptoms (possibly lasting only a few minutes).

  • A weakness or numbness down one side of your body
  • Difficulty with your speech
  • Loss of sight in one of your eyes

In some people these symptoms may be caused by a blockage or partial-blockage of the carotid arteries in the neck.

The scan of your neck is carried out with you either lying on a couch or sitting in a chair and usually takes 10-20 minutes. We recommend you arrive for this scan wearing an open necked shirt or blouse (to save undressing) and no necklaces or large earrings.

Checking the ARTERIAL circulation in your legs:

Basic leg artery test: this is called an "Ankle Brachial Pressure Index (ABPI)" or sometimes just "ankle pressures" or "Dopplers".

Why have you been referred for this test? This is the first test we do if your doctor suspects you have a blockage in your leg arteries. You may have the following symptoms.

  • Painful aching in your leg muscles brought on by walking, especially up hills, followed by relief when resting.
  • Constant burning/aching pain in the feet or toes with some relief gained from hanging your feet down.
  • Toe and foot sores that are not healing.
  • Ulcers that require 4-layer bandaging

This basic test of your leg arterial circulation is carried out with you lying on a couch and usually takes 10-20 minutes.

A small simple ultrasound device is used to "listen" to the blood flow in your feet - the noise you hear is known as Doppler Ultrasound. The Clinical Vascular Scientist can interpret this noise and determine whether your arteries are normal or blocked. Blood pressure readings are also taken from your ankles and your arm, these readings help determine if and how severely your arteries are blocked. In addition we may ask you to do a short "walk test" and then repeat all the measurements.

For this test you only need remove shoes and socks so that we can get to your bare feet and ankles.

Detailed leg artery test:

This is called a "lower limb arterial duplex scan" and is a detailed ultrasound examination of the main arteries in one or both of your legs.

Why have you been referred for this test? The specialist vascular doctor you have seen in the vascular clinic needs to know the precise nature of your disease so that you can have the most appropriate treatment. You will probably have already had the "basic leg artery test" (above) which showed there is a blockage somewhere in your leg arteries. Now this "detailed leg artery test" shows precisely where the blockages are located and how much of a blockage there is.

This test of your leg arterial circulation is carried out with you lying on a couch and can take anywhere between 30 minutes and 1 1/2 hours. The precise length of time depends on the complexity of the disease we find during the scan (something that is impossible to predict), and whether we are scanning one or both of your legs.

For this test we usually start by scanning your stomach, as the leg arteries actually start at the level of your navel (these arteries are known as the iliac arteries). We then scan down your inner leg from groin to knee level (these arteries are known as the femoral arteries). Sometimes we may also scan the smaller vessels in your calf (these arteries are known as the tibial arteries).

For this test we need to get to your bare stomach and legs so you will need to remove your shoes, socks or tights as well as your trousers or skirt.

Checking the VENOUS circulation in your legs:

Deep Vein Thrombosis Scan (DVT scan): this is a scan of the veins in your leg to look for a blood clot.

Why have you been referred for this test? The specialist DVT nurses in the DVT clinic suspect you may have a blood clot in the major veins of your leg. Perhaps you are experiencing the sudden onset of a painful, swollen leg.

The scan of your leg is carried out with you lying on a couch and usually takes 10-30 minutes. For this test we scan down your inner leg from groin to knee (these veins are called your common and superficial femoral veins) and then behind your knee (this vein is known as the popliteal vein) and down your calf (these veins are known as your tibial or calf veins).

For this test we need to get to your bare leg so you will need to remove your shoes, socks or tights as well as your trousers or skirt.

Varicose Vein Scan:

This is a scan of the veins in your leg to identify which veins have damaged (leaky) valves inside them.

Why have you been referred for this test? The specialist vascular doctor you have seen in the vascular clinic needs to know the precise details of your varicose veins so that you can have the most appropriate treatment.

This detailed test of your varicose veins is usually carried out with you standing, and can take anywhere between 20 minutes and 1 hour. The precise length of time depends on the complexity of the veins we find during the scan (something that is impossible to predict), and whether we are scanning one or both of your legs.

For this test we usually scan down your inner leg from groin to ankle (checking the long saphenous vein) and down the back of your calf (checking the short saphenous vein). We may also check any other visible varicosities on your leg wherever they happen to be.

For this test we need to get to your bare leg so you will need to remove your shoes, socks or tights as well as your trousers or skirt.

Areas of excellence

  • Diagnosis of carotid artery disease
  • Diagnosis of lower limb arterial disease
  • Diagnosis of varicose veins
  • Diagnosis of deep vein thrombosis
  • Treatment of axillary hyperhidrosis

Conditions treated

The Vascular Studies Unit is predominately involved in the diagnosis of peripheral vascular diseases. The appropriate treatments are then carried out by the vascular surgeons and/or the vascular radiologists.

An exception to this is the Botox treatment of axillary hyperhidrosis - excessive sweating.

Treatments offered

Botox treatment of hyperhidrosis (excessive sweating) - when small doses of Botox (botulinum toxin) are injected into the skin, it blocks the actions of the nerves that supply the eccrine glands; this prevents the glands from producing sweat. Botox permanently blocks the nerve endings but over about 6-12 weeks new nerve endings grow to replace them. This means that the effects of treatment last for several months (usually 6-12) but eventually they will wear off.

General contact details

Vascular Studies Unit
Level 2, Queen's Building
Bristol Royal Infirmary
Tel: 0117 342 7530
Fax: 0117 342 2443