Arterial Doppler

Arterial Doppler ultrasound assesses blood flow in the arteries of your legs, essential for diagnosing Peripheral Arterial Disease (PAD). This scan examines the main leg arteries (femoral, popliteal, tibial) to detect narrowing, blockages, or reduced blood flow.

PAD commonly causes leg pain when walking (claudication), poor wound healing, or cold feet. Risk factors include smoking, diabetes, high cholesterol, and hypertension. The scan uses colour Doppler to visualize blood flow and measures the Ankle-Brachial Pressure Index (ABPI).

Our vascular specialists provide comprehensive assessment with immediate results and guidance on next steps if PAD is detected. Early diagnosis improves outcomes and prevents disease progression.

Complete Lower Limb Arterial Assessment:

Arteries Examined:

• Abdominal aorta (if indicated)
• Iliac arteries (pelvis)
• Common femoral artery
• Superficial femoral artery (thigh)
• Profunda femoris (deep femoral)
• Popliteal artery (behind knee)
• Anterior tibial artery (front of lower leg)
• Posterior tibial artery (back of lower leg)
• Peroneal artery
• Dorsalis pedis artery (foot)

What We Measure:

Colour Doppler Flow:

• Direction of blood flow
• Flow velocity (speed)
• Turbulence indicating stenosis
• Collateral vessels (bypass routes)

ABPI (Ankle-Brachial Pressure Index):

• Blood pressure in ankles vs arms
• Most important PAD screening test
• Objective measurement of disease severity

Waveform Analysis:

• Triphasic (normal)
• Biphasic (mild disease)
• Monophasic (moderate-severe disease)
• Absent (complete occlusion)

Stenosis Assessment:

• Location of narrowing
• Severity (mild, moderate, severe)
• Single vs multiple lesions
• Calcification degree

PAD Symptoms:

Intermittent Claudication (most common):

• Leg pain when walking (especially calf)
• Pain stops with rest
• Predictable distance triggers pain
• Cramping, aching, or tiredness in legs
• Usually affects calf, but can affect thigh or buttock

Advanced PAD:

• Rest pain (pain even when not walking)
• Pain worse at night, lying down
• Cold feet or legs
• Numbness or weakness
• Color changes (pale when elevated, red when dependent)
• Hair loss on legs
• Shiny, smooth skin
• Slow nail growth
• Non-healing wounds or ulcers
• Gangrene (severe cases)
• Weak or absent pulses

Risk Factors for PAD:

Modifiable:

• Smoking (strongest risk factor)
• Diabetes (doubles risk)
• High blood pressure
• High cholesterol
• Obesity (BMI >30)
• Sedentary lifestyle
• Unhealthy diet

Non-Modifiable:

• Age (risk increases over 50)
• Male gender (higher risk)
• Family history of PAD or cardiovascular disease
• Race (higher in certain ethnic groups)

ABPI Interpretation:

ABPI Value	Classification	Severity
1.0 – 1.4	Normal	No PAD
0.9 – 0.99	Borderline	Possible early PAD
0.8 – 0.89	Mild PAD	Lifestyle changes
0.5 – 0.79	Moderate PAD	Medical treatment
<0.5	Severe PAD	Specialist referral
<0.3	Critical limb ischaemia	Urgent intervention

>1.4: Non-compressible vessels (calcified arteries, common in diabetes)

Why Early Diagnosis Matters:

Prevents Progression:

• Lifestyle modifications most effective early
• Medical therapy can halt disease
• Supervised exercise programmes work best in mild-moderate PAD

Reduces Complications:

• Prevents amputation (severe cases)
• Improves quality of life
• Reduces cardiovascular events (heart attack, stroke)
• PAD is marker of widespread atherosclerosis

Treatment Options:

• Conservative: Exercise, smoking cessation, diet
• Medical: Antiplatelet drugs, statins, blood pressure control
• Interventional: Angioplasty, stenting
• Surgical: Bypass grafting (severe cases)

The Scan Process:

• Remove shoes and socks
• Blood pressure cuffs on arms and ankles
• Doppler probe assesses each artery
• Waveforms recorded
• Colour Doppler imaging
• Takes 30-45 minutes
• Completely painless
• Both legs examined

Preparation:

• No fasting required
• Wear loose trousers or shorts
• Continue all medications
• Bring list of medications
• Inform us if you have diabetes

After the Scan:

Results Discussion:

• ABPI results explained
• Severity of PAD classified
• Location of blockages identified
• Treatment recommendations

Possible Outcomes:

• Normal: Reassuring, alternative diagnosis explored
• Mild PAD: Exercise programme, risk factor modification
• Moderate PAD: Medical therapy, monitoring
• Severe PAD: Urgent vascular surgery referral
• Critical ischaemia: Emergency hospital admission

Follow-Up:

• Normal: Rescreen if symptoms develop
• Mild: Annual monitoring
• Moderate: Regular scans
• Post-intervention: Regular monitoring

Specialist Referral: We provide detailed reports for:

• Vascular surgeons
• Interventional radiologists
• Podiatrists
• Diabetes teams
• GP management