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| Additional Options/Vascular | Vascular Tests FAQ | Vascular Tests Preparations |
Non-Invasive Vascular Laboratory at Duke University Medical Center
Simple, Painless and Cutting-Edge Assessment of Your Arterial Health To help your physician determine optimal care for you.
About us
Under the direction of Dr. Jason Allen, PhD, we are a cutting edge vascular laboratory. Our primary focus is on detecting cardiovascular disease in the pre-clinical (early) stages of development.
The problem
Cardiovascular disease is the number one killer of both men and women in the United States, affecting all age groups. Frequently the first sign of the disease is a clinical event (heart attack, stroke), leading to treatment after the disease has already made significant progress. The challenge for health care professionals lies in the detection and treatment of the “silent” phase of disease progression when there are few, if any, outward symptoms.
What makes our solution different?
Most current cardiovascular risk profiles examine traditional factors, such as cholesterol and blood pressure. We utilize painless ultrasound technology, to look directly at the anatomy of the arteries and their response to perturbation. This allows us to detect past and current cardiovascular disease progression.
Vascular Procedures
We currently offer 5 procedures that address different aspects of your vascular health. These tests may be performed individually, or in combination. All of the tests are non-invasive and involve minimal to no discomfort.
Each test gives you another piece of information to build your comprehensive cardiovascular risk assessment, and enables you and your physician to determine your best individualized course of treatment.
Each test is briefly summarized with a link to further details
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Carotid Artery Assessment - Intimal-Medial Thickness - This is a stable measure of disease progression in the arteries of your neck. It measures the thickening of the artery walls and can identify focal plaque accumulations.
- Endothelial Function Test - This is a dynamic test of the responsiveness of your arteries to a physical stress (increased blood flow), to help determine if the switch for cardiovascular disease progression is currently on or off. The arteries of healthy subjects respond better than those with cardiovascular disease (CVD).
- Abdominal Aortic Aneurysm Screening - This is a weakening of the artery lining which leads to a “bulging” of a section of the vessel. If not detected it can grow over time and eventually rupture, leading to death.
- Ankle Brachial Blood Pressure Index - This test uses blood pressure at your ankles and arms to assess the flow of blood throughout the body. Lack of normal perfusion to the feet may indicate a condition known as peripheral vascular disease (PVD).
- Arterial Stiffness - With ageing and with cardiovascular disease, vessels become more rigid. We assess the rigidity of your arteries system and can track changes in stiffness following lifestyle and/or medication changes.
Fees
These options are not included in the base price of the Duke Executive Health Program, but may be purchased on an package or individual basis. Depending on your selections, you may need to extend your stay. The Appointment Coordinator will work with you to adjust your schedule.
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Vascular Package (5 Procedures) = $1150
Individual tests
- Carotid Artery Assessment - Intimal-Medial Thickness = $400
- Endothelial Function Test = $300
- Abdominal Aortic Aneurysm Screening = $350
- Ankle Brachial Blood Pressure Index = $50
- Arterial Stiffness = $150
($50 extra fee if your Carotid Scan needs to be further read by a vascular certified cardiologist)
Time Requirements
The time required for these procedures varies, depending on the combination of tests selected.
- The total package requires approximately 3 hours
Times for Individual Tests
- Carotid Artery Intimal-Medial Thickness requires approximately 1 hour
- Endothelial Function Test requires approximately 1 hour
- Abdominal Aortic Aneurism Screening approximately 30 minutes
- Ankle Brachial Blood Pressure Index requires approximately 30 minutes
- Arterial Stiffness requires approximately 20 minutes. If this test is done in conjunction with Endothelial Function, no additional time is required.
Test Preparations
In order for the test results to be accurate, there are certain requirements for the day of your appointment as well as the day before, regarding food, drink, exercise etc. Click here to see the details.
Frequently Asked Questions
We have compiled a list of questions and answers to help you with your planning. Click here to see the details.
For more information or to make an appointment
The Non-Invasive Vascular Laboratory is located in the Andrew G. Wallace Clinic, 3475 Erwin Road, Durham, North Carolina, adjacent to the Duke Executive Health Program Suite.
Driving directions and a map of our campus
To schedule an appointment, please contact the Duke Executive Health Program Coordinators. For further information, you can contact us directly at (919) 660-6788 or email us at NIVRLab@duke.edu
Program In-Depth Information...
Carotid Artery Intimal-Medial Thickness
Carotid Artery Intimal-Medial Thickness (C-IMT). This is a stable measure of vessel disease accumulation over the life span and can also identify focal plaques. C-IMT levels have been shown to predict cardiovascular events (heart attack and stroke).
In conjunction with research generating normative data based on age, race and sex, you will receive a prediction of your 10 year risk of cardiovascular events.
We assess three sections of your carotid vessels, the common, bulb and internal arteries, from several angles, to locate diffuse or asymmetrical wall thickening.
The picture on the left shows measurements of the top and bottom walls in the common carotid artery. This picture represents a mild accumulation of plaque. Severe plaque accumulations protrude into the vessel and can obscure blood flow to the brain.
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Endothelial Function Test
This is a dynamic measure to help determine if your arteries are healthy or at risk for cardiovascular disease.
We use ultrasound to measure the change in size of an artery in your arm in response to increased blood flow (a blood pressure cuff inflation and release). Healthy arteries respond better than those with, or at risk for, cardiovascular disease. The response in the arm has been shown to be similar to the response of the coronary arteries and predictive for future cardiovascular events.
The advantage of this test is that it can be reassessed following lifestyle and/or medication changes. This may indicate the benefit of a treatment (see graph below).
The first measurements (red bars) were low and indicated an impaired artery, potentially reflecting current progression of cardiovascular disease. The green bars show an increase in endothelial/vessel function following several changes in treatment.
Abdominal Aortic Aneurysm Screening
The abdominal aorta is the largest blood vessel in the body and runs from the heart to the lower body. An abdominal aortic aneurysm is a weakening of the artery lining which leads to a “bulging” of a section of the vessel just below the branches to the kidneys (see diagram). Over the years, the weak spot can slowly grow with no symptoms. If detected early, a AAA can be regularly monitored and, when the diameter reaches 5.5 cm (≈2inches), it can be surgically corrected. If undetected, an aneurism can rupture, causing internal bleeding and has an 80% fatality rate.
Risk factors for AAA’s are smoking, age, high blood pressure, diabetes, high cholesterol, lack of exercise and obesity. Ultrasound screening for AAA’s for all men ages 65 to 75 who have ever smoked is recommended by the United States Preventative Services Task Force. Anyone with a family member who had an aneurysm is also at increased risk.
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Guide to Abdominal Picture
1. Aorta
2. Heart
3. Abdominal Aortic Aneurysm
4. Normal Aorta
5. Kidney |
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Ankle Brachial Blood Pressure Index
Ankle Brachial Blood Pressure Index. This test uses blood pressures at your ankles and your arms to assess the flow of blood to the lower extremities. Lack of normal perfusion to the feet may indicate a condition known as peripheral vascular disease (PVD). PVD is a form of cardiovascular disease and can lead to leg pain and difficulty walking if left untreated. The results of this test will allow your doctor to determine if PVD is a potential problem for you.
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Arterial Stiffness
Arterial stiffness is a measure of the rigidity of your vessels. With ageing and with cardiovascular disease, vessels deposit calcium and collagen, making them more rigid. We use applanation tonometry on your carotid, radial and femoral arteries, to measure the conformation and velocity of blood pressure pulse waves throughout your vascular system. Analysis of these waveforms provides us with information about workload on the heart, coronary perfusion, aortic and systemic stiffness.
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