17606 Vascular Ultrasound

Overview

A vascular ultrasound is a painless scan that uses sound waves to build pictures of your blood vessels. 'Vascular' means to do with blood vessels, and 'ultrasound' means using high-pitched sound you cannot hear. It shows your arteries (the tubes that carry blood away from your heart) and your veins (the tubes that bring blood back). A special version called a Doppler or duplex scan also shows how fast blood is flowing and in which direction. The number 17606 is simply an administrative code used to record this type of scan — it is not a diagnosis.

Yes. Vascular ultrasound is one of the most common tests used to check circulation, and clinics carry out many every day.

Anyone can be sent for one. It may be a young person with varicose veins, someone in middle age with leg cramps when walking, or an older adult having their neck arteries or an aneurysm checked. The scan is safe in pregnancy and for children, although it is only used in children when there is a clear reason.

Symptoms

Common symptoms

• Cramping or aching in the legs or calves when you walk, which eases after a short rest
• Swelling in one leg, or legs that feel heavy and tired
• Bulging or twisted veins (varicose veins)
• Cold, pale or blue fingertips, or fingers that change colour in the cold
• Numbness, tingling or a 'pins and needles' feeling in the hands
• A throbbing or pulsing lump in the tummy
• Dizziness, fainting or a brief loss of vision, which can lead to a neck artery check
• A whooshing or pulsing sound in one ear
• A foot or leg wound that is slow to heal

Symptoms in children

• Vascular ultrasound is rarely needed in children, but it may be used to look at a birthmark or an unusual tangle of blood vessels
• It can check the blood flow through a dialysis access point in a child with kidney disease
• It may be used after an injury to make sure blood is flowing normally
• Children usually cope well, and a parent or carer can stay in the room throughout

Symptoms in older adults

• Checking the neck arteries after a mini-stroke (a 'transient ischaemic attack' — a stroke-like episode that gets better within 24 hours)
• Monitoring a widened section of the main tummy artery (an aneurysm)
• Checking for narrowed leg arteries that cause pain when walking
• Checking dialysis access points or bypass grafts
• Reviewing veins before varicose vein treatment

Causes

Main causes

• Narrowing of arteries caused by fatty build-up (atherosclerosis) — this is the most common reason for a scan
• Blood clots in veins, such as deep vein thrombosis
• Weak or damaged valves in leg veins, which cause varicose veins
• A widened, ballooned section of an artery (an aneurysm)
• Checking a dialysis access point, stent or bypass graft
• Conditions where fingers and toes over-react to cold, such as Raynaud's
• Unusual tangles of blood vessels (vascular malformations)

Risk factors

• Smoking or vaping
• Diabetes
• High blood pressure
• High cholesterol
• Being over 50
• A family history of heart or circulation problems
• Kidney disease
• Long periods of sitting still, such as on a long flight or after surgery
• Pregnancy, which can bring on varicose veins
• Being overweight

When to see a doctor

See a doctor urgently if:

• Sudden swelling and pain in one leg
• A leg or foot that is cold, pale, painful or numb
• A foot wound that is not healing
• Brief stroke-like symptoms, even if they pass quickly
• Sudden severe tummy or back pain

Book a routine appointment if:

• Leg cramps or aching when you walk that keep coming back
• Varicose veins that are uncomfortable or changing
• Cold or colour-changing fingers and toes
• A family history of aneurysm or early heart disease
• A routine follow-up for a known aneurysm, stent or graft

Diagnosis

The ultrasound scan is itself the test. A trained sonographer (a health professional who specialises in ultrasound) moves a small handheld probe over your skin. The probe sends out sound waves and picks up the echoes, and a computer turns these into pictures on a screen. You may be asked to hold your breath for a few seconds or to lie in different positions. For leg artery checks, blood pressure cuffs may be wrapped around your arms and ankles. For vein checks, the sonographer may press gently on your leg with the probe. It does not hurt, although the gel may feel cool.

Tests that may be done

• Duplex or Doppler ultrasound — shows pictures and blood flow together
• Ankle-brachial index — a simple blood pressure comparison between arm and ankle
• Blood tests for cholesterol, blood sugar and kidney function
• CT or MRI angiography — more detailed pictures using dye, used only when needed
• A repeat scan after a few months to see whether anything has changed

What to expect at your appointment

You will usually lie on a couch in a dimly lit room. The room is kept quiet so the sonographer can see the screen clearly. Wear loose, comfortable clothing, or you may be given a gown. You may need to remove socks and shoes. The scan takes around 15 to 45 minutes depending on which vessels are being checked. Most people feel nothing more than the gentle pressure of the probe. You can eat and drink normally beforehand and drive yourself home afterwards. The sonographer cannot usually tell you the result on the day, because a doctor reviews the images first. Results normally go to the person who referred you within a few days to a couple of weeks.

Treatment

The scan does not treat anything itself — it gives you and your doctor a clear picture so the right plan can be chosen. What happens next depends entirely on what the scan shows. For many people the result is normal, or shows only mild changes, and the advice is simply to keep active and manage risk factors. If something is found, treatment may range from lifestyle changes and compression stockings to a small procedure or, less often, surgery.

Self-care at home

• If you smoke, stopping is the single most helpful thing you can do for your circulation — ask your doctor or pharmacist for support
• Stay active: regular walking helps train the muscles and vessels in your legs
• Keep feet clean, dry and moisturised, and check them daily for cuts or sores, especially if you have diabetes
• Raise your legs when resting if you have vein problems, unless told otherwise
• Wear well-fitting shoes and avoid tight socks or garters that press on the skin
• Wear compression stockings only if a health professional has measured and recommended them
• Keep warm in cold weather, and wear gloves if your fingers are sensitive to cold
• Take any prescribed medicines for blood pressure, cholesterol or blood sugar exactly as advised

Medical treatments

Treatment is tailored to what the scan finds. Common approaches include: a structured walking programme for narrowed leg arteries; compression stockings for vein problems; medicines prescribed by your doctor to lower cholesterol, control blood pressure or reduce the chance of clots; and small procedures carried out through a tiny tube or a needle to widen a narrowed artery or close off problem veins. Your doctor will explain the options, the benefits and the drawbacks in your own situation, and you will be able to ask questions before deciding.

When is surgery considered?

Surgery is only considered when other options are not enough. Examples include repairing a large or fast-growing aneurysm, clearing or bypassing a severely blocked artery that is causing pain at rest or a non-healing wound, or removing badly damaged veins. These are decisions made together with a specialist team after a full discussion of risks and benefits.

Living with this condition

Many people have a vascular ultrasound, get a clear answer, and carry on with life much as before. If the scan shows a circulation problem, it is usually something you manage over time rather than something that stops you. Keeping a simple routine — moving regularly, checking your feet, taking medicines as prescribed, and going to follow-up appointments — makes a real difference.

Lifestyle tips

• Build walking into your day, even in short bursts, and rest when you need to
• Avoid standing or sitting still for long stretches; stretch your legs and ankles regularly
• Put your feet up for a while each afternoon if you have vein problems
• Cut down on salt and processed food to help your blood pressure
• Limit alcohol and keep to a healthy weight
• If you smoke, get help to stop — it is never too late for your circulation to improve

Diet and exercise

A balanced diet rich in vegetables, fruit, beans, wholegrains and oily fish supports heart and vessel health. Try to be active on most days — a brisk walk, swimming, cycling or dancing all count. If walking brings on leg pain, a common and effective approach is to walk until the pain comes, rest until it eases, then walk again. This 'stop-start' pattern gradually builds up your walking distance. Ask your doctor or a physiotherapist to help you set a safe starting level.

Mental health and emotional wellbeing

Being sent for a scan, or learning you have a circulation problem, can bring worry, low mood or anxiety. That is very common and understandable. Talking to someone you trust, writing down your questions before appointments, and asking your doctor to explain anything that is unclear can all help. If worry is affecting your sleep, appetite or daily life, please tell your doctor — support is available and it is a normal thing to ask for.

Prevention

You cannot 'prevent' needing a scan — it is a test, not an illness. But the circulation problems a scan looks for are often helped by the same healthy habits: not smoking, staying active, eating well, and keeping blood pressure, cholesterol and blood sugar in a healthy range. Even small changes are worth making.

Vaccines

There is no vaccine for circulation problems. Keep up with your routine vaccinations, including flu and pneumonia vaccines if your doctor advises them, because infections can be harder on the body when you have a long-term health condition.

Screening programmes

In the UK, some screening is offered routinely. For example, men aged 65 and over in England are invited for a one-off ultrasound check of the main tummy artery (the abdominal aortic aneurysm screening programme). If you are not sure whether you are eligible, ask your GP surgery. Other checks, such as blood pressure and cholesterol tests, are offered as part of routine NHS health checks for eligible adults.

Complications

If left untreated

• Narrowed leg arteries that are not managed can lead to pain at rest, skin breakdown and, rarely, tissue damage
• An aneurysm that is not monitored can enlarge and, very rarely, burst — which is why regular scans matter
• A vein clot that is not treated can, rarely, travel to the lungs
• Unmanaged varicose veins can lead to skin changes, itching and discomfort
• A non-healing foot wound can become infected if it is not cared for

Long-term outlook

The outlook is generally good. Most people who have a vascular ultrasound get clear answers and simple, effective advice. Where a problem is found, spotting it early usually means more options and better results. Many circulation problems can be slowed or steadied with lifestyle changes and the medicines your doctor recommends, and procedures are available when they are needed. Going for the scan is a positive step, not a reason to panic.

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