Upper Extremity Peripheral Arterial Examinations
Atherosclerotic disease and other vascular disorders may also affect the arteries of the arms and fingers. The noninvasive test procedures used to identify these circulatory problems are similar to those described for the diagnosis off blockage of the arteries of the legs.
Indications for Testing
- Subclavian artery stenosis
- Digital ulcers or gangrene
- Generalized symptoms of pain, numbness or aching
- Changes in skin color or temperature
- Differentiation of Raynaud’s Phenomenon form Digital Artery Occlusive Disease
- Thoracic Outlet Syndrome
- Postoperative followup
Segmental Systolic Pressure Measurements and Photoplethysmography (PPG) are test procedures used for identification of disease in the arteries of the arms and fingers. The tests are performed as described previously for the leg arteries. You will be asked to wear a hospital gown for these procedures also.
Digital Cold Sensitivity Testing may be used to determine the quality of blood flow to the fingers. The test is simple and painless. Arm blood pressures are first measured by segmental systolic pressure measurement techniques (see above). A small blood pressure cuff or infrared sensor is then placed on each finger and the pressures are measured at room temperature. The pressures are again measured after you have immersed your fingers in ice water for a predetermined time period. The blood pressure will increase in response to temperature changes in normal vessels. In the presence of spasm or blockage of the arteries, pressure will fall below normal, or may become unrecordable, indicating the severity and nature of digital arterial disease.
If your physician suspects that the arteries to your arms are being compressed within the thoracic outlet space of the shoulder by a cervical rib, muscle, or ligament, he may request Bi-directional Doppler Waveform Analysis or Segmental. Systolic Pressure Measurements with your arms placed in varied positions. These Thoracic Outlet Maneuvers may demonstrate that blood flow through the vessels to the arms is hindered by compression in the shoulder region when the arm is in certain positions. The technologist will first record the blood pressures or Doppler velocity waveforms with your arms resting in your lap and then again while you hold them in various positions. If a particular position results in compression of the artery, the blood pressure will drop and the Doppler velocity wave contour will change, indicating the reduction in blood flow.
Duplex Scanning and Doppler Color Flow Imaging will be used in a manner similar to that described for the legs (Lower Extremity Peripheral Arterial Examinations) to demonstrate narrowing of the arteries due to atherosclerotic disease or dilation of the vessel due to aneurysm.
The above test procedures will yield results, which can determine the presence of obstructive disease in the arteries, which carry blood to your arms and fingers and can direct your physician in selecting the proper medical treatment for you.