Vascular - Lower Limb Vascular Assessment - Doppler Ultrasound ABPI/TBPI

Why is completing a Doppler assessment important?

The Doppler assessment helps to assess the blood supply in your arms, legs and foot as part of a routine lower limb vascular assessment.

In this assessment a trained clinician will feel your foot for pulses, then use the Doppler ultrasound probe or PPG unit (Photoplethysmography sensor around your toe) to listen to the pulse signals and obtain an absolute systolic pressure (blood pressure reading).

Finally, they will measure the blood pressure in your arms and legs or foot, to compare them. The results will help the clinician form an opinion on the arterial circulation in your legs and feet and this will help them choose the most appropriate treatments or onward referrals for you.

Where will the test take place?

The test will either take place in your own home or in a clinic setting depending on the service you have been referred to.

What does the test involve?

The test will be explained to you by the clinician. This will ensure you understand the results. If you have any worries at any time before or during the test do not be afraid to ask.

The test will take about 10-30 minutes. To get the best results you will be asked to lie as flat and still as possible until the test is complete. The duration of the whole assessment can take up to an hour.

If you have a wound on your leg or foot the clinician will cover and protect it for the test.

A blood pressure cuff will be placed around first one arm, then the other arm, then each leg just above your ankle.

Gel is applied to your skin to help the clinician listen to the sound of your blood supply. The Doppler machine may be noisy and this is normal. If you have pain in your legs, it may be advisable to take some painkillers just before your assessment.

The blood pressure cuff is inflated and then deflated slowly just like when you have your blood pressure taken. When the test is finished the clinician will sit you up.

If a TBPI is to be undertaken an appropriate sized toe cuff is placed around the toe, this is then attached to a sphygmomanometer and the PPG unit (Photoplethysmography). A PPG sensor is applied to apex of your toe (with no wounds) and the unit is switched on. The clinician will inflate the toe cuff lightly and slowly until the waveform disappears, this is then slowly released until the waveform reappears.

Your clinician will explain all this to you in detail prior to this procedure being undertaken.

When will I get my test results?

You will normally be given the Doppler results on the same day as your appointment.

The clinician will discuss the treatments that are available to you, which may include compression therapy, wound treatment, medicine and lifestyle changes, support around exercise and reduction of smoking. You may also be referred for further vascular assessment/opinion, or referral to another speciality if indicated. The clinician will explain the reasons for this and what will happen next.
 
If you have a wound on your leg or foot the treatment will usually be started on the same day as your test. The clinician will arrange further appointments for wound review, changes of dressing or compression therapy for you.

The clinician will tell you when your next Doppler test appointment will be, which is usually between 3 - 12 months.

What can I do to help?

If you will not be home or unable to attend the allocated clinic appointment, then please contact the relevant service to rearrange.

You may also be asked to confirm or cancel your appointment if indicated on your appointment letter.

It is very important that you are available at home or attend your clinic appointments at the agreed time.

Wear loose fitting clothing so that the clinician can assess your arms and legs. If attending a clinic please bring wide-fitting shoes, ideally with velcro straps or trainers with you, in case the clinician needs to apply a bandage on your leg or foot.

If you have a wound or sore on your leg or foot, please bring the dressings you are currently using with you or have a supply available for the visiting clinician.

Please have available a list of your current prescribed medication and a urine specimen which will be routinely tested on the first review/assessment.

Telephone Numbers for each service:

District Nurse Liaison
Clinic:  ______________________________
Location:  ______________________________    
Tel:  ______________________________

Podiatry Service
Clinic:  ______________________________
Location:  ______________________________
Tel:  ______________________________

Vascular Service
Clinic:  ______________________________
Location:  ______________________________
Tel:  ______________________________     

Tissue Viability Service
Clinic:  ______________________________     
Location:  ______________________________
Tel:  ______________________________

Leg Circulation Service
Clinic:  ______________________________
Location:  ______________________________
Tel:  ______________________________     
 
Lymphoedema Service
Clinic:  ______________________________
Location:  ______________________________     
Tel:  ______________________________

Treatment Room Service
Clinic:  ______________________________     
Location:  ______________________________
Tel:  ______________________________

Other Location:  ______________________________

Further Advice

If you have any concerns or question about the information in this leaflet, please feel free to contact the team that is seeing you and they can answer any query you may have.