Common Indications:
• Symptoms of TIA (Unilateral weakness, numbness, tingling, speech difficulties, stroke with recovery)
• Amaurosis fugax
• Carotid bruit
• Vertebrobasilar insufficiency (dizziness, imbalance, loss of consciousness)
• Follow-up of known carotid stenosis
• Post intervention follow-up (carotid endarterectomy, stent, etc.)
• Trauma in the distribution of the carotid artery
Common Indications:
- Chronic arterial occlusive disease
- Symptoms of claudication (calf, thigh and/or hip pain with walking or exercise that resolves with short rest)
- Symptoms of rest pain
- Ulceration
- Gangrene
- Acute arterial occlusion (pain, pallor, pulselessness, parasthesias, and paralysis)
- Aneurysm
- Pseudoaneurysm
- Follow-up post PTA/stenting
- Follow-up post bypass grafting
Common Indications:
- Limb pain, swelling, or tenderness
- Limb cyanosis and/or erythema
- Symptoms of embolus (peripheral or pulmonary)
- Shortness of breath
- Chest pain
- Dyspnea
- Hemoptysis
- Respiratory distress
- Low-grade fever of unknown origin
- Varicosities induration
- Hyperpigmentation
- Ulceration
Common Indications:
• Change in the bruit or thrill of the graft
• Prolonged dialysis times
• Elevated venous pressure found during dialysis
• Difficult needle placement for dialysis
• Abnormal lab values
• Arm swelling, and digital pain, numbness or tingling
Hypertension affects over 20% of the adult population. Renovascular disorders are among the rare secondary causes of hypertension and include renal arterial lesions from either atheroma or fibromuscular dysplasia. Other findings in the renal vascular exam include intrinsic renal parenchymal disease, mesenteric stenosis or extrinsic compression, and aneurysm.
Common Indications:
• Hypertension (new onset or uncontrollable)
• Follow-up post PTA/stenting
• Follow-up bypass grafting
• Follow-up renal allograft
Mesenteric Vascular Evaluation
Of the three intra-abdominal branches supplying the majority of flow to the gastrointestinal organs, an acute obstruction has a very dramatic clinical presentation and requires immediate measures with elevated patient risk. A less severe chronic flow restriction allows for the development of collateral vessels, yet may result in the more intermittent symptoms seen below.
Common Indications:
• Abdominal pain associated with eating
• Fear of food
• Chronic diarrhea
• Unexplained weight loss
Hepato-Portal Evaluation
Often, patients with suspected pathology within the liver have other disease processes at work and may present with complicated symptoms. Mint Medical evaluates the vasculature that feeds and drains the liver, determines the direction of the portal vein flow (whether hepatopetal or hepatofugal), and identifies portal vein thrombosis, hepatic vein thrombosis, and patency and status of porto-systemic shunts and Transjugular Intrahepatic Portosystemic Shunts (TIPS).
Common Indications:
• Suspected portal hypertension with esophageal/bleeding varices
• Abdominal pain
• Abdominal distention
• Ascites
• Hepatic encephalopathy
• Venous hum
• Cruveilhier-Baumgarten Syndrome
• Budd-Chiari Syndrome with sudden abdominal epigastric pain with nausea and vomiting
• Hepatomegaly
• Splenomegaly
• Abdominal collateral vein distention
• Follow-up post porto-systemic shunting (including TIPS).
Arteriovenous Fistula
It occurs when an artery and vein that are side-by-side are damaged and the healing process results in the two becoming linked. For example, after catheterizations, arteriovenous fistulas may occur as a complication of the arterial puncture in the leg or arm.
Pseudoaneurysm
It is also known as a false aneurysm & results from an injury to an artery that causes blood to leak and pool outside the injured artery’s wall. A pseudoaneurysm is generally a consequence of an iatrogenic trauma, most likely a previous invasive medical procedure that necessitated intrusion into an artery, for example to place a stent.
Arterial Dissection
It’s a tear or seperation of the layers of the artery wall, which may be spontaneous or tramatic.
Common Indications:
• Pulsatile abdominal mass
• Presence of an aneurysm at another anatomical location
• A history of hypertension with family history of Abdominal Aortic Aneurysm (AAA) and age >50 years
• Surveillance of known abdominal aortic or iliac artery aneurysm for increase in size
• Aortic coarctation
• Back pain
• Evidence of distal emboli
• Evidence of lower extremity inflow arterial disease
• Surveillance of arterial vascular intervention/reconstruction
• Abdominal and/or groin bruit
• Screening approved with the Medicare SAAAVE Act