Why would my doctor refer me to a vascular surgeon if my ABI is normal

Posted by anet @anet, Oct 26 1:52pm

Recently I saw my primary care doctor about pain in my legs and feet. He did an ABI which was normal and also an ultrasound on my legs to check for blood clots. No evidence of blood clots. I have never smoked and I do not have high cholesterol. I am not diabetic. I called to ask why he referred me and the nurse said because my knee was swollen and I had complained of foot pain. What is he looking for?

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You may not have clots, per se, but you may have vascular disease or a narrowing someplace that makes what your heart wants to do for your legs very difficult. A vascular surgeon might have an idea why you're swollen there, and it might be related to blood carriage, such as in veins that are narrow, maybe lenticular valves that need to be bypassed…not sure. But what do you have to lose?

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I am going to go to the appointments. If he does not find a problem I am hoping he can send me to an orthopedic doctor or a podiatrist. I really think that’s what I need

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@anet

I am going to go to the appointments. If he does not find a problem I am hoping he can send me to an orthopedic doctor or a podiatrist. I really think that’s what I need

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I received a report from my vascular surgeon today.
The conclusion on the DVT scan was no evidence of DVT seen and No reflux is seen.

The lower extremity arterial scan:
Minimal plaque see throughout
No increase in velocity seen.
Triphasic waveforms seen to the distal PTA and ATA

Conclusions: minimal plaque seen throughout bilaterally. No significant stenosis seen.

Have not talked to the doctor yet. Appointment tomorrow. Nov 22

Does anyone know if the No increase in velocity seen is good or bad?

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@anet

I received a report from my vascular surgeon today.
The conclusion on the DVT scan was no evidence of DVT seen and No reflux is seen.

The lower extremity arterial scan:
Minimal plaque see throughout
No increase in velocity seen.
Triphasic waveforms seen to the distal PTA and ATA

Conclusions: minimal plaque seen throughout bilaterally. No significant stenosis seen.

Have not talked to the doctor yet. Appointment tomorrow. Nov 22

Does anyone know if the No increase in velocity seen is good or bad?

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I would interpret these results as very positive!

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@keithl56

I would interpret these results as very positive!

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That is what the doctor said! He said my problem was more than likely a pinched nerve or from my rheumatoid arthritis. I will keep going until I find some help. He said he doesn’t need to see me unless something else comes up.

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When fluids are forced from behind (ie, under pressure) to pass through a stenosis, or a narrowing, the velocity increases as it passes the stricture and then slows again when the aperture across the artery increases to 'normal' again. Doppler ultrasound, for one, can detect the velocity differences as the wand is pressed here and there along, say, the carotid artery. So, if they claim that they detected no significant velocity changes in the usual trouble spots (which are well known by now), then it means there are no stenoses or clots. And yes, that's good!

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