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Vascular Assessment

Essential for those with diabetes, current or ex-smokers, those with kidney failure or cardiovascular disease.

Vascular assessment involves looking at the arterial, venous and microvascular supply of the foot, leg and lower limb.

Beecause the vascular system is effectively a highway that feeds from very large vessels down to much smaller vessels, we are able to tell the health of your lower limb through assessment of the blood supply further down; a good blood supply at the feet will mean that your vascular health further up your leg is fine. If the blood supply at the feet is poor, then I will try to identify how far up the problem is so that you can be referred appropriately.

The most basic vascular assessments for feet include a visual check to assess skin quality and health as well as looking at (toe) hair and nail growth. I will also assess the temperature of the feet, checking for differences in temperature, how long it takes for the skin to 'pink up' after I press on the skin, and also check your pulses.

If your pulses are poor, I will listen to them with a Doppler machine, this allows me to hear the quality of movement of blood. It also allows me to check for certain cardiac irregularities such as atrial fibrillation - a leading cause of strokes (however I can also do this with my fingers, but by listening to your pulses, I have an extra layer of certainty to write to your GP with.

I may also assess your Ankle-Brachial Pressure Index. This is a method of assessing the ratio of your blood pressure in your arms and the blood pressure in your ankles. We then try to work out how evenly distributed the blood pressure is, and if there are differences, then further assessment from a vascular specialist may be required.

Depending on the severity of your symptoms, I can assess your blood supply as far up as your femoral artery. If you are coming in for vascular assessment and have been a heavy smoker, had extended periods of poor control of your diabetes, or get a numb / cramping / tingling pain in your buttocks, thighs, or calves whilst walking which goes within a minute or two of stopping, please ensure you wear loose fitting clothes to your appointment so that I can assess higher up your leg. Your dignity will be maintained at all times if this is necessary and you will be informed of all actions that may need to be undertaken.

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