Vascular Specialists Tyler Texas
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Non-Invasive Peripheral Arterial Evaluation (Test)

What is a peripheral artery examination?

When you have a peripheral arterial examination at Vascular Specialists of East Texas, it will consist of one or more of the following tests:

Arterial duplex with ultrasound

Peripheral Arterial Duplex is a type of noninvasive vascular ultrasound study done to assess for blockage or narrowing of the peripheral arteries of the arms and/or legs. Ultrasound duplex scanning can provide additional information that may guide therapeutic decisions.  The location and severity of arterial narrowing and occlusions can be identified.  The information from duplex scanning can help determine if arterial disease might be appropriately treated with an endovascular intervention.  The type of treatment and the technical approach can be guided by the duplex scan findings.   Information from the duplex scan can help patients be better informed about their options.  Duplex scanning after intervention can provide objective information about the success of the procedure and serial follow-up examinations can identify recurrent problems at an early stage.

Lower Extremity physiologic testing (Segmental Pressures/ PVR)

Evaluation of the arterial supply to the lower limbs is done by measuring blood pressures at various levels and by evaluation of the arterial pulse characteristics.  Blood flow is evaluated with an ultrasound Doppler flow detector.  Arterial pressures in the lower extremities are compared to the pressures measured in the arms.  These tests are usually referred to as segmental pressure measurements and pulse volume recording (PVR).

Ankle brachial index (ABI)

An ABI is performed by measuring blood pressures at a single level.  Arterial pressures in the lower extremities at the ankle and toes are compared to the pressures measured in the arms. This is reported as a ratio and used as an indicator for PAD (Peripheral Arterial Disease).

 What is PAD (peripheral arterial disease)?

PAD is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease, your extremities, usually your legs, don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking.

What are the indications or symptoms for a peripheral arterial evaluation?

  • While many people with peripheral artery disease have mild or no symptoms, some people have leg pain when walking (intermittent claudication). Intermittent claudication symptoms include muscle pain or cramping in your legs or arms that's triggered by activity, such as walking, but disappears after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is most common.  The severity of intermittent claudication varies widely, from mild discomfort to debilitating pain. Severe intermittent claudication can make it hard for you to walk or do other types of physical activity.
  • Leg numbness or weakness
  • Coldness in your lower leg or foot, especially when compared with the other leg
  • Sores on your toes, feet or legs that won't heal
  • A change in the color of your legs
  • Hair loss or slower hair growth on your feet and legs
  • Slower growth of your toenails
  • No pulse or a weak pulse in your legs or feet

What can I expect during the exam?

A complete examination of both extremities takes approximately 50 minutes.  It is performed in a darkened room lying on an exam table. A technologist will place pressure cuffs on the arms, legs, and toes to perform the blood pressures of the extremities. For the arterial duplex exam, Images of the arteries will be taken using the ultrasound equipment.  A transducer is placed on the extremity with a small amount of water soluble ultrasound gel. 

Patient Instructions

  • Allow 30 minutes for one arm or leg duplex study
  • Allow an additional 20 minutes for each additional extremity.
  • Allow 40 minutes for a segmental/PVR study
  • No smoking for at least an hour before the test.
  • Please wear loose collar or button up shirt with short sleeves if your arms are to be examined.
  • For leg studies, you will remove your pants, socks & shoes.


Please call us with questions or to schedule an appointment.

Vascular Specialists of East Texas