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Vascular Ultrasound of the Lower Extremities 

What is Vascular Ultrasound?

Vascular ultrasound is a type of noninvasive imaging exam that uses high-frequency soundwaves to penetrate the body and create images and videos of the vascular, or circulatory system. The images of veins and arteries these ultrasound exams produce can be used to diagnose a variety of vascular diseases.

Registered vascular technologists, or RVTs, are trained to conduct these specialized ultrasound exams. They can be used to examine various parts of the body, such as the upper or lower extremities. Lower extremity vascular ultrasound exams specifically focus on the veins and arteries in the legs.

What does a Vascular Ultrasound of the Lower Extremities Diagnose?

Lower extremity vascular ultrasound can be used to diagnose several conditions that affect the vascular system. These include varicose veins, deep vein thrombosis, and peripheral vascular disease. Varicose veins are veins that have become swollen or enlarged, most often found in the legs. They may appear as blue or dark purple lines just beneath the skin’s surface and sometimes have a bulging or twisted appearance. Varicose veins are the result of a weakening of the blood valves within the veins, which leads to blood pooling.

Varicose veins may be caused by obesity, limited movement, or pregnancy. The condition can be treated in a variety of ways based on severity, from compression stockings to laser treatment and surgery. In some cases, varicose veins are solely a cosmetic concern, but in other cases they may be indicative of a more serious condition such as deep vein thrombosis.

Deep vein thrombosis, or DVT, is a condition characterized by blood clots within the veins. These blood clots can disrupt or block blood flow altogether. They usually occur in the legs, typically only in one leg at a time. Symptoms include pain, swelling, or discoloration. DVT can be dangerous because it can lead to a pulmonary embolism, which occurs when a blood clot breaks off in the legs and becomes lodged in the lungs. DVT may be caused by vein injuries, chronic illness such as heart and lung diseases, or limited movement or confinement. Treatments for DVT include thrombolytic drugs, blood thinners, and compression stockings, among others.

Another condition that can be diagnosed by lower extremity vascular ultrasound is peripheral vascular disease, or PVD. PVD is characterized by the narrowing of the peripheral blood vessels, such as those located in the legs. The narrowing of blood vessels results in restricted blood flow and can lead to blockages. PVD is commonly caused by atherosclerosis, or the buildup of plaque along the inside of the arterial walls. Some common risk factors for PVD include older age, high blood pressure and cholesterol, obesity, or tobacco use. PVD can typically be treated with lifestyle changes, such as quitting smoking or increasing exercise. Other treatments include medication or, in severe cases, surgical intervention.

Vascular Ultrasound Exam Procedure

Vascular ultrasound of the lower extremities can help diagnose these conditions by determining if a blood clot or plaque buildup is present. Vascular ultrasound exams also use Doppler technology to determine velocity and direction of blood flow.

The vascular ultrasound exam procedure is efficient, painless, and noninvasive. Ultrasound machines consist of a console, a video monitor, and a handheld device called a transducer. The transducer emits harmless soundwaves that create images of the veins and arteries. The RVT will apply a gel to the transducer and use it to compress the skin, which can help determine if the veins are stiff or inflexible. They can view the images and videos on the ultrasound monitor in real time. After the exam, results are sent to an interpreting physician and the referring provider.

Vascular ultrasound of the lower extremities is an accurate and noninvasive way to help diagnose vascular diseases such as varicose veins, deep vein thrombosis, and peripheral vascular disease. Patients who think they may be at risk for these conditions should speak to their provider to see if a vascular ultrasound exam is necessary.

Guest Contributor: Jordan Galerkin

Sources: 1. Deep Vein Thrombosis (DVT). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557

2. Peripheral Vascular Disease. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-vascular-disease 3. Types of Ultrasound. Ultrasound Quotes. https://www.ultrasoundquotes.com/blog/doppler-vs-duplex/ 4. Varicose Veins. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643