A screening exam differs from a formal study in that it is a very limited evaluation. You can think of a screening exam as answering a yes/no question, “Do I have it or not?” It is not intended to answer the question, “How severe is it?” If you have a positive finding on a screening exam, then typically you are advised to undergo a formal imaging study. There are three major types of vascular screening exams:
Screening exams are used for vascular disease because many of these diseases are “silent,” meaning that people may be unaware they have the problem until they suffer a major event (such as a stroke, ruptured aneurysm, or gangrene). Screening exams have also helped to educate the general public about vascular disease. It is a somewhat shocking statistic that more people have PAD than all types of cancer combined, yet 75 percent of adults in the U.S. don’t know what PAD is.
It is important to realize, however, that it is not wise to screen all people. It is very unlikely that a person under the age of 60 with no risk factors for vascular disease will have positive findings on a screening exam. Similarly, a man who is 70 and has hypertension and has smoked for 40 years and has three family members who have all died of ruptured aneurysms should probably have a formal imaging study of his abdomen rather than a screening exam. A woman who has had carotid surgery and gets regular surveillance ultrasound exams with her vascular surgeon does not need a screening carotid study. Also, a person with symptoms of claudication or a non-healing foot wound needs a formal evaluation, not a screening exam.
Vascular surgeons support selective screening of at-risk populations of people. What does that mean? It means it may be reasonable to consider screening if you are over the age of 60 and have risk factors for atherosclerosis or aneurysm (hypertension, high cholesterol, diabetes, greater than 100 pack smoking history, and/or family history for heart attack, stroke, or AAA). It is best to discuss your concerns with your doctor.