Overview

Our vascular lab offers patients a convenient, professional alternative to the congested hospital setting for non-invasive Ultrasound and Physiologic vascular testing. Use of state-of-the-art ultrasound equipment by a highly trained technologist enables accurate readings of disorders affecting human arteries and veins, and test results assist physicians in diagnosing circulatory problems.

The studies, performed by a registered vascular technologist, are generally painless and of short duration. The results are interpreted by our team of vascular surgeons. In addition, follow-up studies are performed to measure stability, improvement or progression of the patient's vascular disease.

All patients are treated with dignity and respect, and our goal is to make each visit as comfortable and pleasant as possible.

Carotid Duplex Examination

A Carotid Duplex Examination is an ultrasound test of the carotid arteries in the neck that lead to the brain. This study is used to detect a blockage or narrowing of the carotid arteries which may cause a stroke.

The Carotid Duplex Examination takes about 30 minutes. There are no special preparations. You should where a loose fitting shirt or blouse that does not have a high neck. You will lie on an exam table in a darkened room while the technologist performs the exam.

Your doctor will receive the test results in approximately 2 working days.

What kind of symptoms might I experience if there were a blockage in my carotid arteries? There are several signs and symptoms that you may experience such as:

• Carotid bruit (a noise or murmur heard in the neck when your doctor listens to your neck with a stethoscope)
• Loss of balance
• Vertigo (dizziness)
• Aphasia (inability to speak)
• Numbness or weakness on one side of your body
• Amaurosis Fugax (transient blindness in one eye)
• Syncope (fainting)

Arterial Evaluations

An Arterial Evaluation of the legs is a noninvasive procedure used to screen for peripheral vascular disease (PVD) or blockages in the arteries.

The technologist will wrap a blood pressure cuff around each ankle, calf and thigh, and measure the blood pressure at these levels. By analyzing measurements made with blood pressure cuffs on the ankles, calves and thighs, narrowing of the arteries can be determined.

Your doctor may request that the test be done with exercise as well. The exercise portion of this study involves walking on a treadmill at a normal rate for 5 minutes.

Your doctor will receive the test results in about 2 working days.

What kinds of symptoms might I experience if I had PVD? There are many signs and symptoms that you may experience such as:

• Pain in the legs, feet or toes (especially with walking or exercise, that is relieved with rest)
• Coldness in the feet or legs
• Paleness of the feet when elevated
• Numbness or tingling in the feet or toes
• Blue or red discoloration of the feet or toes

Venous Doppler Evaluation

A Venous Doppler Examination uses ultrasound to create a two-dimensional picture of your veins. This test is helpful in diagnosing a blood clot or a DVT (Deep Vein Thrombosis.) This exam may also be used to measure the size of the vein being used for bypass surgery.

What kind of symptoms might I experience if I had a deep vein thrombosis? There are many signs and symptoms that you may experience such as:

• Limb swelling
• Pain/Tenderness
• Acute shortness of breath (occasionally a pulmonary embolus or blood clot in the lung is caused by a blood clot in the leg which has broken off a traveled to the lung)

Venous Reflux Examination

A Venous Reflux Examination is a noninvasive test that is used to test the valves in the veins of the legs.

A small sensor will be taped to your leg. The technologist will ask you to pump your foot up and down several times. The pumping action pushes blood up the leg toward the heart. The sensor measures how quickly the blood returns down to the ankle. From these measurements, the technologist can determine if the valves are working properly (venous valvular insufficiency.)

Your doctor will receive the test results in approximately 2 working days.

What kind of symptoms might I experience if I have venous valvular insufficiency? There are many signs and symptoms that you may experience such as:

• Chronic lower leg/ankle swelling
• An ulcer (or sore) that won't heal
• Skin discoloration of the lower legs or ankles

More Information

For more information on vascular conditions, tests, and treatments, visit the VascularWeb web site. This site is provided by the Society for Vascular Surgery.

Meet our Registered Vascular Technologists

Greg Dugas, R.V.T. graduated from the Cardiovascular Technology Program at Grossmont College in San Diego, CA. in June, 2001 and became a Registered Vascular Technologist in February of 2002. Greg has worked in the medical field since 1995 and within the vascular community for more than five years. He was employed as a Vascular Technologist at Fletcher Allen Health Care in Burlington, VT. He also worked as a Vascular Technologist with Dynamic Imaging and with Hashimoto Imaging prior to coming to ASBS. His understanding of hemodynamics and vascular ultrasound has made him a valuable asset to ASBS.

Patricia F. Powers, B.S., R.EEG.T, R.V.T. holds a Bachelor of Science Degree in Education from the University of Wisconsin - Oshkosh. Following her undergraduate studies, she studied medical diagnostics, becoming licensed as a Registered Electro-Encephalographic Technologist (R.EEG.T.) in 1988, and a Registered Vascular Technologist (R.V.T.) in 1992. Pat has worked in the field of vascular medicine for the past 15 years. She was employed as a Vascular Technologist at United Western Medical Center in Santa Ana and St. Joseph Hospital of Orange, and Lead Vascular Technologist at Little Company of Mary Hospital in Torrance. She also served as Technical Director of BBI Vascular Laboratories in Anaheim. Her diagnostic skills and detailed knowledge of anatomy and hemodynamics continue to provide accurate information to vascular surgeons and other physicians.

About our Vascular Surgery Specialists

	Dr. Adoumie graduated medical school in 1988 at the State University of New York, Stony Brook where he was elected to the Alpha Omega Alpha honor medical society. He took his surgical internship at the New England Medical Center (Tufts University, Boston) and went on to continue his surgical residency training at McGill University hospitals in Montreal, Canada. He pursued his vascular training as a fellow at the University of Ottawa where he graduated in 1994. He was on the teaching faculty at the University of Louisville. Currently, Dr. Adoumie maintains his affiliation as a teaching faculty to Harbor UCLA Medical Center. His current practice includes both advanced endovascular interventions in addition to traditional open surgical therapy.
	Dr. Kaviani was born in Teheran, Iran in 1971 and emigrated to the United States shortly after the Iranian Revolution in 1979. He grew up in Newport Beach, California and after graduating from high school, moved to the east coast where he attended the University of Pennsylvania. He completed his undergraduate studies majoring in Neuroscience with honors in 1992, and attended medical school at Boston University. After graduating from medical school, he began his internship in General Surgery at The University of California San Francisco- East Bay, and completed his senior residency and chief residency in General Surgery at Yale University School of Medicine in New Haven, Connecticut.
	After attending medical school at the Creighton College of Medicine in Omaha, Nebraska. Receiving his M.D. degree in 1988. Dr. Lee completed his internship at the University of Colorado and finished his surgical residency at the University of Missouri. He pursued a private practice of general and laparoscopic surgery in Illinois. His interest in vascular and endovascular surgery, stimulated him to pursue a vascular fellowship at St. Francis Hospital in Roslyn, New York. Dr. Lee is involved in developing the endovascular program at our participating hospitals. Dr. Lee's interest also includes extensive experience with the use of radiofrequency as well as laser ablation technique in treating patients with varicose veins.
	Dr. McNamara attended Louisiana State University School of Medicine and trained in General Surgery on the LSU Surgical Service Charity Hospital, which was at that time the largest and oldest Teaching Hospital in the United States. In 1979 he traveled to California for Postdoctoral Training in Peripheral Vascular Surgery at USC, and in 1980 began surgical practice in the South Bay treating vascular problems both medical and surgical including the use of angiography, angioplasty, and stenting techniques. Additionally, he is expert in the treatment of venous disease especially varicose veins and chronic venous insufficiency. Dr. McNamara has served as Chief of Surgery at both Little Company of Mary Hospital and Torrance Memorial Medical Center.