It is common for Professor Varcoe to order at least one imaging investigation when assessing your blood vessels. Usually duplex ultrasound will be performed as it is simple, radiation free and non-invasive. Often this will be followed by a second test that uses contrast dye to image the blood vessels and gives clearer images of the problematic area.
The below is a list of the more common tests that Professor Varcoe is likely to order.
Ultrasound
Duplex ultrasound is a non-invasive form of imaging that can be used to examine both arteries and veins using sound waves at high frequency. It not only provides a two dimensional image of each blood vessel but can also be used to look at the direction and speed of blood flow. Most studies take 30 to 60 minutes.
This information can be used by A/Professor Varcoe to evaluate most vascular disorders, including
•Carotid occlusive disease
•Deep vein thrombosis
•Leg artery disease
•Arm artery disease
•Aorto-iliac occlusive disease
•Varicose veins
•Aneurysms in your abdomen or extremities
For most of these tests little preparation is required and you can go about your normal activities immediately afterward. Occasionally studies will require you to fast. It is best to ask about this when your appointment is made. Prof Varcoe’s preferred imaging centre is the Vascular Diagnostic Centre in Randwick.
CT Angiogram
Computed Tomography (CT) scanning is one of the most commonly used tests required by doctors to diagnose medical conditions and plan for their treatment.
It utilises x-rays emitted from a spiralling source within a CT scanner gantry to provide 2-dimensional cuts through the human body. Sophisticated computer systems then reconstuct the data from these images to give detailed 3-dimensional images like the ones seen on the right.
Vascular specialists are often looking for specific information about the arteries and veins, examining for narrowing, blockage, impingement or aneurysm. To achieve clear images of these blood vessels contrast dye must be injected (usually through an intravenous drip in the arm) and scanned as it passes through the blood vessel of interest. This often gives a short lasting, warm, flushed sensation as it passes through the patient’s body.
The test usually takes 30-60 minutes and requires little preparation, however you should enquire as to whether fasting is required when you make the appointment.
Angiogram
An angiogram is an outpatient procedure that uses x-rays to visualise the blood flow through arteries and veins after the injection of contrast dye.
It is performed under local anaesthesia by inserting a thin plastic tube called a catheter into the artery or vein of the groin. Any blood vessel in the body can then be assessed by moving the catheter into a position where it may inject the contrast dye. An angiogram is a term used when arteries are inspected, a venogram is the same process but looking at veins.
Usually, all regular medications can be taken prior to an angiogram, however please check with A/Professor Varcoe beforehand especially with regards to any blood thinning medication you may be taking. You will be required to fast for 6 hours prior to any angiogram. You will be observed by the medical team in hospital for 4 hours after the test and will be unable to drive yourself home.
Bruising is common afterward and usually requires no specific treatment. Any increasing swelling or pain in the groin or leg should be reported to A/Professor Varcoe’s office as soon as possible.
Magnetic Resonance Imaging (MRI)
MRI uses radio waves and a magnetic field to derive 2 and 3-dimensional images of your body which is particularly good at evaluating soft tissues, arteries and veins. The test involves lying flat on a hard table for 30-60 minutes and being passed through a doughnut shaped scanner. Contrast may be administered through an intravenous cannula if required.
Most people tolerate the test without too much difficulty although you may be ineligible if your body contains metal prostheses such as pacemakers, artificial joints or surgical clips, or if you suffer from claustrophobia.