Noninvasive Vascular Diagnostic Evaluations VAL provides noninvasive vascular diagnostic evaluations for patients with a variety of arterial and venous conditions. Evaluations include cerebrovascular (extracranial and intracranial), upper and lower arterial, upper and lower venous, and abdominal vascular. All tests are administered by qualified/certified technologists, reviewed by a RVT-certified vascular surgeon, and a final physician report is generated within 24 hours to 48 hours. VAL is committed to providing quality expeditions vascular diagnostic testing services to the medical community and has done so since 1984.

VAL is accredited by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) and in 1992 was one of the first thirty-six vascular laboratories in the US to earn accreditation

VAL offers services to area hospitals, clinics, and nursing homes on 24 hour, 7 day a week basis. VAL is located at 8595 Picardy Avenue, Suite 320, Baton Rouge, LA. VAL is a Medicare participant and is a participant in all healthcare plans as well as the Louisiana Medicaid Program.

Peripheral Arterial Evaluations

Arterial blood flow in the upper and lower extremities are evaluated by several indirect testing methods. These methods are comprised of segmental limb pressures and pulse volume waveforms, which are recorded at different levels to determine the location and degree of arterial occlusive disease. Mild exercise testing is sometimes performed to identify disease not apparent by resting pressures and waveforms.

Vasospastic disorders, such as Raynaud’s disease, can be evaluated by recording segmental pressures and waveforms, to include the digits, and documenting the patient’s response to cold water immersion. Additional specialized arterial testing, using indirect methods, is done for Thoracic Outlet Syndrome (TOS) and for erectile dysfunction.

Postoperative bypass vein graft evaluation is performed by using duplex ultrasound to image and assess flow within the bypass to include the anastomotic sites and native vessels. Duplex ultrasound is used to identify aneurismal disease of peripheral vessels.

Examination Indications

• Claudication
• Rest pain
• Ischemic lesions
• Acute emboli/thrombi
• Aneurysmal disease
• Arterial bypass assessment
• Amputation level
• Vasospastic disorders (Raynaud’s)
• Thoracic Outlet Syndrome
• Erectile Dysfunction

Examination to order:
Lower/upper arterial exam
Upper arterial TOS exam
Upper arterial Raynaud’s exam
Bypass graft exam or arterial duplex exam
(aneurysm)

Peripheral Venous Evaluation

Noninvasive assessment of the upper and lower extremity veins is performed by duplex ultrasound (real-time ultrasound imaging and pulsed and /or color Doppler). This test detects acute or chronic thrombosis of the extremities.

Post phlebitic syndrome or chronic venous insufficiency is evaluated by duplex ultrasound by detecting valvular incompetence.

Duplex ultrasound is used to assess the superficial veins, lower or upper extremities, for use in lower limb revascularization and dialysis access placement.

Examination Indications

• Limb Swelling
• Limb pain
• Pulmonary embolus (shortness of breath, chest pains)
• Post phlebitic syndrome
• Chronic venous insufficiency
• Varicose veins
• Vein suitability for bypass/dialysis access

Examination to order:
Bilateral or unilateral upper/lower venous exam
Upper/lower venous exam for vein suitability

Abdominal Vascular Evaluations

Duplex color ultrasound is used to evaluate the abdominal vessels to detect arterial occlusive disease or aneurysm formation.

Adominal Aorta Evaluation
The abdominal aorta is assessed by duplex ultra-sound from the ziphoid to the umbilicus with measurements taken to identify any dilatation that would indicate an aneurysm.

Renal Vascular Evaluation
Noninvasive assessment of renal arteries and renal parenchymal blood flow is used to detect hemodynamically significant renal artery stenoses, parenchymal disease, and information regarding kidney size and structural abnormalities.

Visceral Vascular Evaluation
Splanchnic arterial circulation is evaluated by duplex color ultrasound to detect significant lesions in the celiac and the mesenteric circulation.

Examination Indications

• Hypertension
• Post prandial pain
• Abdominal aortic aneurysm
• Abdominal bruit

Examination to order:
Abdominal aorta exam
Renal artery exam
Visceral artery exam

Cerebrovascular Evaluations

Extracranial Evaluation
Bilateral carotid and vertebral arteries are assessed using duplex color ultrasound. Duplex ultrasound is used to visualize plaque within the vessel/s and the Doppler (pulsed and color) detects any alterations in blood flow velocity and turbulence. The degree of obstruction is then calculated and reported in specific categories of diameter reducing stenosis.

Examination Indications

• Cervical carotid bruits
• Transient unilateral visual symptoms
• Transient ischemic attack
• Stroke
• Vertebrobasilar insufficiency-subclavian obstructions
• Known carotid artery stenosis
• Pulsatile cervical masses or aneurysms
• Postoperative carotid endarterectomy

Examination to Order:
Carotid vascular exam

Intracranial Evaluation
Transcranial Doppler techniques are used to provide penetration of the skull to directly detect arterial flow in the major basal arteries of the brain.

Examination Indications

• Severe stenosis or occlusion of the extracranial arteries
• Severe stenosis or occlusion of the major of the major basal intracranial arteries
• Subarachnoid hemorrhage
• Suspected brain death
• Cerebral embolization

Examination to order:
Transcranial Doppler exam