Patient assessment - investigations
The investigations can be divided into 2 groups - specific for the leg and general.
GENERAL
 | Blood tests - to check on your blood count, kidney function, cholesterol and triglyceride levels. Blood will also be taken for a cross-match to get blood ready for a bypass operation. |
| ECG - this is a heart tracing to check that the heart rhythm is normal and to see if there is any evidence of damage to the heart (e.g. an old heart attack). |
| Echocardiogram - this looks at the heart with ultrasound to see if it is beating properly. |
| Chest X-ray - may be needed before the operation. |
SPECIFIC
These tests look at the arterial tree of the leg to determine where and how severe the disease is. On the basis of these tests, decisions can be made about the best way to treat the problem.
| Colour flow duplex - this is ultrasound with doppler. It provides pictures of the artery and the doppler allows measurement of blood flow. It tells us about parts of the arterial tree that are blocked or narrowed and the severity of that narrowing. Some surgeons carry out bypass surgery on the basis of this investigation. |
| Arteriogram - this is described in more detail in the angiogram section. It gives us a road-map of the arteries. It is an invasive test (involves puncturing the artery in the groin with a needle) and is reserved only for those patients where we are considering some form of intervention. The following example shows a case with blockage of the iliac arteries on the right side (see anatomy for details). The kidneys can be clearly seen at the top: |
The following angiogram shows the arteries in the calf. It can be seen that the anterior tibial (AT) and posterior tibial (PT) arteries are both blocked. The only artery that is present is the peroneal (PE). It is also narrowed in parts and any bypass graft would have to be taken beyond the narrowed segments:
