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Carotid Intima-Media ickness (cIMT) Carotid intima-media thickness (cIMT) is a FDA-approved test that measures the thickness of the two inner layers – called the intima and the media – of the carotid arteries, the major arteries of the neck, which carry oxygenated blood from the heart to the brain. Most important, the cIMT can identify actual atherosclerosis (cholesterol plaque growing in the wall of the artery, between the intima and the media), which is oen undetectable with tests that only examine the arterial "pipes" through which blood flows. A cIMT scan can also be used to find out how "old" your arteries are. As you age, it is normal for your artery wall to gradually get thicker, but in some people arterial aging is accelerated, particularly if they smoke or have high blood pressure, high cholesterol, or diabetes. erefore, your "arterial age" can be compared to your chronological age, based on norms for your age and gender developed through large studies of healthy people. Carotid Duplex Ultrasound Unlike cIMT, which directly examines the arterial wall for plaque, the carotid duplex test looks for indirect evidence of disease by measuring blood flow through the carotids. In other words, it's based on the plumbing concept of cardiovascular disease and checks for blockages in the "pipes." Carotid duplex is typically performed on patients with symptoms of reduced blood flow to the brain, such as temporary blindness in one eye or brief loss of the ability to talk, understand speech, or move. It's also an appropriate test for stroke survivors and for monitoring the effects of surgical procedures to improve blood flow through the carotids, such as stent placement. It is not recommended for screening patients for atherosclerosis. Carotid duplex results are expressed as percentages, indicating the extent to which the diameter of the artery is narrowed (stenosis). Each lab sets its own range of "normal" results. For example, University of Massachusetts's clinical vascular service defines 1 to 29 percent stenosis as the "normal" range, while higher numbers are considered increasingly abnormal. One hundred percent stenosis (also called "occlusion") means that the vessel is completely blocked, with no blood flow. Severely obstructed carotid arteries are usually treated with surgical procedures, such as balloon angioplasty and stent placement or endarterectomy, an operation to remove plaque buildup. Ankle-Brachial Index (ABI) is test is used to diagnose peripheral artery disease (PAD), a circulatory problem in which plaque buildup narrows arteries, reducing flow of oxygenated blood to your extremities (usually the legs). About eight million Americans have PAD, including up to 20 percent of people older than age 60. If you have coronary heart disease, there is a one in three chance that you also have PAD. And if you smoke, here's yet another reason to snuff out the habit: Smokers have up to six times higher risk for PAD. Nearly half of the people who develop this debilitating disorder are current or former smokers. e classic symptom is leg pain or cramps when you're walking that improve with rest. Other warning signs include smooth, skinny skin, atrophy of leg muscles, cold, numb toes, and sores or ulcers on the feet or legs that don't heal. However, up to 40 percent of people with PAD – a serious, but treatable condition – have no symptoms, so the disorder oen goes undiagnosed and untreated. at's dangerous, since having PAD quadruples or even quintuples the risk for heart attack or stroke. PAD can oen be treated with lifestyle changes, including quitting smoking, exercising more, and eating a healthy diet. You may also need medication, such as drugs to help prevent blood clots, such as daily aspirin therapy or Plavix. Abdominal Aortic Aneurysm Scan About 1.1 million Americans ages 50 to 84 have abdominal aortic aneurysm (AAA, pronounced "triple-A"), a weak, bulging area in the lower portion of the body's largest artery, which supplies blood to the abdomen, pelvis, and legs. Like a balloon, the larger the aneurysm becomes, the more likely it is to burst, causing massive bleeding that's fatal in up to 90 percent of cases. Ruptured aortic aneurysm kills about 30,000 Americans per year. Although abdominal aortic aneurysm is oen stereotyped as a disease of male smokers, about 22 percent of the people who develop it are nonsmokers and 40 percent of AAA fatalities occur in women. While the exact causer isn't yet known, many of the same conditions that accompany heart disease are contributing factors, including smoking, obesity, diabetes, high cholesterol, high blood pressure, and genetics. Not only can the AAA scan reliably detect an aneurysm, if you have one, but it can also identify calcification (atherosclerosis) in the artery wall that signals increased risk for heart attack or stroke. If an aneurysm is detected, your healthcare provider may advise a watch-and-wait approach (monitoring the aneurysm with periodic ultrasound scans to see if it's getting bigger) or refer you to a vascular surgeon, depending on the size of the bulge. An aneurysm measuring 1.6 inches in diameter is classified as small, medium aneurysms measure 1.6 to 2.2 inches, and large ones exceed 2.2 inches. Surgery generally isn't recommended for small aneurysms, since the risks of the procedure outweigh the risk of rupture. Ultrasound is a very safe, inexpensive, and painless way to check for vascular disorders, including peripheral artery disease (PAD), aortic abdominal aneurysm, and plaque that could trigger a heart attack or stroke. Unlike X-rays, which can only detect hard, calcified plaque (stable plaque that contains flecks of calcium), the carotid intima- media thickness ultrasound scan discussed in this section can also detect so, vulnerable plaque – the kind that can cause heart attacks and strokes. The Ultrasound Advantage Page 46 | Abby's Magazine - www.AbbysMag.com