A complete guide to your lower extremity arterial duplex ultrasound — a scan that maps blood flow through the arteries of your legs to detect peripheral artery disease.
Many patients have never had this type of scan before. Here is exactly what will happen — no surprises.
Completely painless and non-invasive. Ultrasound uses sound waves — no radiation, no needles, no discomfort. Most patients find the experience relaxing.
You lie comfortably on your back for most of the exam. The sonographer will work from the groin downward.
The exam begins at the groin where the common femoral artery — the main inflow artery for the leg — is identified and assessed.
The sonographer traces the superficial femoral, popliteal, tibial, and peroneal arteries — documenting flow velocity and characteristics at each level.
At any point where flow velocity is elevated, the sonographer slows down to characterize the degree of narrowing and its hemodynamic significance.
The shape of the Doppler waveform at each level tells the cardiologist about inflow and outflow conditions — important context for any disease found.
Your report maps all arterial segments, grades any stenosis or occlusion found, and provides clinical correlation and recommendations.
Your cardiologist report is written in plain language, but here are the specific measurements and terms you may encounter — and exactly what they mean.
A normal arterial waveform in the leg arteries. Three distinct components reflecting forward flow, brief reversal, and forward flow again. Loss of triphasic pattern suggests disease proximal to the measurement point.
Flow speed at the measurement point. Focal doubling or more of velocity compared to adjacent segments indicates significant stenosis.
Typically graded as: less than 50% (mild), 50–74% (moderate), 75–99% (severe), or occlusion (no flow). Each grade has different management implications.
A ratio comparing ankle blood pressure to arm blood pressure. Below 0.9 suggests PAD; below 0.5 suggests severe disease. May be performed in conjunction with duplex.
Small arteries that develop to route blood around a blockage. Their presence on imaging indicates a chronic occlusion rather than acute.
Calcified plaque appears bright on ultrasound and may cause acoustic shadowing. Soft plaque is less visible but potentially more unstable.
Your report will clearly state whether follow-up is needed and how urgently. Here is what each outcome typically means.
No significant abnormalities. Share your report with your primary care physician. Consider repeat screening in 1–3 years based on your risk profile.
Minor findings that warrant monitoring. Your report will specify follow-up timing and any lifestyle recommendations.
Clinically significant findings requiring physician review. Your report will indicate appropriate urgency.
Findings requiring prompt evaluation. We will contact you directly in addition to delivering your report.
No referral needed. $397 all-inclusive. Results from a board-certified cardiologist within 24–48 hours.