PERIPHERAL ARTERIAL DISEASE (PAD) & CHRONIC VENOUS INSUFFICIENCY (CVI) ASSESSMENT

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Peripheral Artery Disease

Peripheral artery disease is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. When you develop peripheral artery disease (PAD), your extremities, usually your legs, don't receive enough blood flow to keep up with demand. As plaque builds up the following occurs: 1. Plaque compromises blood flow when it narrows the artery more than 50%. 2. This leads to a lack of oxygenated blood to the lower extremities. 3. The more severe the blockage, the more oxygen starved the tissue becomes with progressive symptoms.

Early onset of PAD goes mostly undiagnosed until severe symptoms are already prevalent. The PAD Assessment Machine allows baseline physiologic testing to be completed in under 15 minutes by any trained medical assistant that enables early diagnosis and prevention. Incredibly easy to use and intuitive, many full arterial studies can be performed daily in any setting. Including Family Practices, Internal Medicine, InstaCare Locations, Cardiology Clinics, Podiatry Clinics, Endocrinology Clinics, Nephrology Clinics and Home Health and Hospice Services. Testing is reimbursable through CPT codes 93922, 93923 and 93924. The most commonly performed test is 93923, with a national reimbursement average of $117.36.

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Chronic Venous Insufficiency

With cufflinks on the lower thigh, upper and lower calf and big toe the PAD Assessment Machine can diagnose the exact location of plaque buildup and blood flow issues. It also tests for Chronic Venous Insufficiency (CVI). CVI is a progressive medical condition in which the valves that carry blood from the legs toward the heart no longer function, causing blood to pool in the legs and the veins to swell. Varicose veins, which are often misunderstood as a purely cosmetic issue, can progress to this more serious condition if left untreated. Healthy leg veins are designed to allow blood to flow against gravity from the legs back up toward the heart. Inside the veins are tiny valves that open and close to help control the flow and pressure. CVI occurs when stresses on the venous system like pregnancy, age or standing for long periods of time weaken and stretch vein structure. When the veins become weakened or diseased, the blood flow is obstructed and blood pools in the legs. This impaired blood flow (or reflux) causes veins to expand, lose form and protrude from beneath the skin.

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Test Result Interpretation

Diagnostic data is transmitted and stored in a HIPAA-compliant cloud. This platform is able to accommodate a wide variety of health assessment models so that practitioners can access data for remote interpretation, and specialists can collect and analyze data from other diagnostic devices. Remote View is a secure cloud-based portal for vascular disease test review and collaborative treatment planning. Offices testing with PAD devices are linked to interpreting vascular specialists, free of charge, who provide expert review of studies via the Remote View platform. Remote View streamlines the interpretation process with navigation tools for expediting the viewing of study results and related images (e.g. a picture of a patient's foot ulcer, pre and post images of revascularized arteries), generation of impressions as well as recommendations, and secure portals for authorized administrators to process claims. Remote View allows Vascular Specialists to collaborate with Internists, Podiatric Physicians, Endocrinologists, Nephrologists, Primary Care and others in the early identification of cardiovascular disease thereby ensuring high quality, cost-effective care.

PAD caused lack of blood flow will lead to the following symptoms:

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  • Claudication (pain while walking).

  • Small Fiber Neuropathy.

  • Leg Pain (Burning, Stabbing, Shooting or Prickly).

  • Leg Swelling, Discoloration, Flaking.

  • Rest Pain, Numbness or Tingling.

  • Ulcerations

  • Gangrene

  • Raynaud’s

  • Diabetes with Circulatory Complications.

  • Lower extremity embolism or thrombosis.

Signs of PAD and CVI

Signs of PAD and CVI

PAD is very Prevalent:

  • 8-12 million Americans have PAD

  • 1/3 of smokers over age 50

  • 1/3 of diabetics over age 50

  • 1/3 of patients over age 70

  • 75% of people with PAD have heart disease

  • Over 30% mortality rate within 5 years

Who Should Be Tested:

Any patient 35 or older with a familial history of Diabetes or Cardiovascular Disease. Any patient 50+ with a history of smoking or diabetes should be screened as well as all patients 70+. All patients demonstrating indications through the below questions or have abnormal screening results from an ABI Test. Finally, any patient that is being considered for a lower extremity surgical procedure should be tested.

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Questions You Should Ask Yourself or Your Patient

  1. Do you have foot, calf, buttock, hip or thigh discomfort (aching, fatigue, tingling, cramping or pain) when you walk which is relieved by rest?

  2. Do you have a history of cardiovascular disease or diabetes and experience any pain or selling at rest in your lower legs or feet?

  3. Do you have a history of cardiovascular disease or diabetes and experience leg, foot or toe pain that often disturbs your sleep?

  4. Do you have an ulcer on your thigh, calf, ankle, foot or toe that is slow to heal?

  5. Do you have diabetes and unusual hair loss or skin discoloration in your legs?

  6. Do your fingers or toes feel numb or cold in response to temperature changes or stress?

  7. Have you suffered a severe injury to your legs or feet?

  8. Do you have an infection of the legs or feet that may be gangrenous (black skin tissue)?

  9. Have you had blockages in your coronary or heart arteries?