1. Carotid imaging - more info

There is now clear evidence that patients suffering amaurosis fugax, transient ischaemic attacks (TIA) or a minor stroke in the carotid territory should have urgent carotid investigation and, when appropriate, surgery within four weeks of symptoms. Regrettably, GP’s frequently find patients wait weeks or months to see a consultant who do not have access to rapid carotid imaging.

IVS can provide rapid and reliable duplex ultrasound investigation of carotid, vertebral and subclavian artery disease within days of the onset of symptoms. Appropriate patients could then be referred directly to a vascular surgeon for urgent carotid surgery or angioplasty.

2. Deep vein thrombosis (DVT) - more info

Currently GP’s have little option but to refer patients with possible DVT to an A&E department. In most cases, after a long wait sitting with their leg dependent, these patients will be investigated by d- dimer and started on anti-coagulants. The patient then needs to return to hospital days or even weeks later for a definitive investigation, often showing that anti-coagulation was unnecessary. Occasionally, occlusive DVT involving the pelvic veins has been missed by d-dimer assay with tragic consequences.

Colourflow duplex ultrasound is the most reliable way to confirm, or exclude, a DVT and may demonstrate a different diagnosis (Baker’s cyst, venous incompetence, haematoma, muscle tear etc).

IVS can provide reliable (and portable) DVT imaging within 24hours of referral.

3. Aneurysm Screening - more info

GP’s frequently feel an abdominal pulse which they think may be an aortic aneurysm (AAA). A simple investigation by duplex imaging at less than half the cost of an out- patient consultation would be valuable for patients with no other indication for a vascular opinion. Ultimately the national screening committee and the Department of Health intend to introduce population screening for AAA, probably at the age of 65 years.

IVS has invested in high quality portable ultrasound scanners for AAA screening. Until national funding becomes available, we can offer an on-demand service as part of a carotid or DVT service or in a local hospital covered by IVS.

4. Varicose veins - more info

Many GP’s are aware that only a proportion of patients with varicose veins (VV) are eligible for treatment in the NHS. Convenient access to a diagnostic service would assist GP’s in their decision on when treatment should be offered. Furthermore, many consultant surgeons treating VV have no access to duplex imaging and frequently offer inappropriate surgery or sclerotherapy as a result. Convenient but accurate VV investigations would assist GP’s in their decision on whether to refer patients for consultation and guide surgeons on the surgery required (including day case surgery).

Using duplex ultrasound, IVS can investigate deep and superficial veins identifying sites of venous incompetence, reflux times and previous deep vein thrombosis. This service can be provided by IVS at a local hospital or in the community.