Angiogram image interventional radiology from Modern Vascular

What is an Angiogram?

Outpatient facilities like Modern Vascular provide patients with noninvasive treatment options that intervene in the effects of chronic diseases like Peripheral Artery Disease (PAD), that if left untreated may lead to amputation and even death. Early diagnosis and prompt treatment can lower a person’s risk of dying from untreated Peripheral Artery Disease.

In order to address moderate to severe blockages in patients with PAD additional diagnostic tools and interventions are necessary. A diagnostic test that doctors use to identify blocked or narrow blood vessels is called an angiogram, in other words, X-rays of the blood vessels. ¹ These X-rays provide images of the blood vessels in many different organs, and in patients with PAD, the focus is on the lower extremities, the legs, and the feet.

Physicians use angiogram results to diagnose a series of diseases ² including:

  • Aneurysms
  • Atherosclerosis
  • Pulmonary Embolisms/Blood Clots
  • Vascular Stenosis
  • Congenital Abnormalities (in the blood vessels or heart)

How are Angiograms performed?

Traditional angiograms are performed by doctors by inserting a long, narrow tube called a catheter into an artery located in the arm, upper thigh, or groin. Then they inject contrast dye into the catheter and take X-rays of the blood vessels. ³

The contrast dye improves the visibility of the blood vessels on X-ray images. A physician requests an angiogram when they need to understand what’s happening inside arteries of the lower extremities.

Contrast materials help distinguish or “contrast” selected areas of the body from surrounding tissue. This helps physicians diagnose the severity of medical conditions like Peripheral Artery Disease, by improving the visibility of specific organs, blood vessels, or tissues.

Not all angiograms involve X-ray machines, however. Doctors can also perform angiograms using CT scans and MRI scans. ³

Analyzing Results

Our physicians use angiograms to analyze the flow of blood in the lower extremities or legs down to the toe. An abnormal angiogram result may indicate that a person has one or more blocked arteries.

In these cases, the doctor may choose to treat the blockage during the angiogram to revascularize the pedal loop.

Intravascular Ultrasound

Intravascular ultrasound (IVUS) uses a transducer or probe to generate sound waves and produce images of blood vessels.4 When used to evaluate the arteries, IVUS can show the entire artery wall and provide important information about the amount and type of plaque buildup, which can help measure the degree of blockage. Ultrasound does not use ionizing radiation, has no known harmful effects, and can provide clear pictures of soft tissues that are not well seen on x-ray images.

This is typically used for patients in addition to the angiogram to evaluate the severity of PAD.


There is a very low risk associated with patients and angiograms in terms of developing major complications afterward. That being said, the more invasive the procedure, for instance utilizing a catheter in the heart, does have some risks.

Other risks can be associated with renal failure and allergies to contrast dyes. If you or a patient you’re advocating for has a sensitivity be sure to share this information with your vascular specialist in order to facilitate accommodations.


  1. Vancouver General Hospital Cardiac Cathlab. VGH Cardiac Cathlab Why do I need an angiogram Comments. (n.d.). Retrieved December 21, 2021, from
  2. Eske, J. & Martinez, K. (n.d.) What is an angiogram? Uses, procedure, and results. Medical News Today. Retrieved December 21, 2021
  3. ACR, R. S. N. A. (2021, July 20). Contrast materials. Retrieved December 23, 2021
  4. Yammine H, Ballast JK, Arko FR. Intravascular ultrasound. In: Sidawy AN, Perler BA, eds. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 30. Retrieved December 23, 2021
Arteries and Veins Blood Vessel Differences

The Difference Between Veins & Arteries

We often get questions regarding the similarities and differences between veins and arteries. We have noticed that there seems to be some confusion between the two, and oftentimes people think that they are the same thing. We want to help people understand the key similarities and differences between arteries and veins.

Blood vessels help circulate blood throughout your body. They form a complete loop, starting and ending at the heart. The human body contains around 60 thousand miles of blood vessels. There are three types of blood vessels: arteries, veins, and capillaries. These vessels work together to form the cardiovascular system.

The Cardiovascular System

Let’s get to the heart of the matter, the cardiovascular system. It starts and ends with the heart, keeping a continuous and controlled movement of blood that delivers nutrients and oxygen to every cell in the body through arteries, veins, and capillaries in between.1 The cells of the body rely on this system to get everything that they need to function properly.

There are two types of circulation processes: pulmonary circulation and systemic circulation.

Pulmonary Circulation

Pulmonary circulation is when unoxygenated blood is sent to the lungs to become oxygenated and to remove carbon dioxide. The unoxygenated blood comes into the right side of the heart before being taken to the lungs for oxygenation and then finally delivered to the left side of the heart.

Systemic Circulation

Systemic circulation is when oxygenated blood that has been delivered to the left side of the heart is delivered to the rest of the body to provide oxygen and nutrients to the cells of the body.

Read 5 Tips for Improved Circulation

Pulmonary circulation blood flow between heart and lungs
Veins Vectors by Vecteezy

What Do Arteries and Veins Have in Common?

Arteries and veins are two of the body’s main types of blood vessels. Arteries are blood vessels that carry oxygen-rich blood away from the heart to the body. Veins are blood vessels that carry blood that is low in oxygen from the body back to the heart for reoxygenation.

How Can You Tell the Difference?

In terms of function, arteries and veins are quite different from one another. A key difference between arteries and veins is that the arteries carry oxygenated blood to all body parts, whereas veins carry the deoxygenated blood to the heart, with the exception of pulmonary arteries and veins.

Arteries have thicker walls because they deal with the pressure of the blood forcibly moving away from the heart. Veins don’t have to deal with as much pressure, but they do have to deal with the forces of gravity. There are valves in the veins to prevent blood from flowing backward or pooling that can become damaged. This can cause a person to develop varicose veins.

What are Veins?

Visually speaking, veins are more commonly identifiable because of superficial veins, which are closer to the surface of the skin. Pulmonary veins are in charge of transporting oxygenated blood to the heart from the lungs. Systemic veins, located throughout the body from the legs up to the neck and arms, transport deoxygenated blood back to the heart. There are also deep veins that are located deep within the muscle tissue.

Common Venous Disorders

  • Chronic venous insufficiency
  • Deep vein thrombosis
  • Excessive blood clotting
  • Superficial venous thrombosis (phlebitis)
  • Varicose and spider veins

What are Arteries?

Carrying blood away from the heart in two distinctive pathways there is the systemic circuit and the pulmonary circuit. Systemic arteries carry oxygen-rich blood towards tissue whereas pulmonary arteries carry oxygen-depleted blood from the heart to the lungs where it can acquire fresh oxygen.4 There are a few types of arteries including elastic arteries that have a thick middle layer so they can stretch in response to the pulse of the heart. Muscular arteries5, draw blood from elastic arteries and branch into resistance vessels. Arterioles are the smallest division of arteries that transport blood away from the heart. They direct blood into the capillary networks.

Common Arterial Diseases 4

  • Abdominal Aortic Aneurysm
  • Thoracic Aortic Aneurysm
  • Coronary Artery Disease
  • Carotid Artery Disease
  • Peripheral Arterial Disease
  • Vertebrobasilar Disease
  • Renal Vascular Disease
  • Thoracic Outlet Syndrome

Learn about interventional radiology and how endovascular procedures differ from open vascular surgeries.

Are Veins or Arteries Related to Peripheral Artery Disease?

The peripheral arteries supply oxygenated blood to the body, and the peripheral veins lead deoxygenated blood from the capillaries in the extremities back to the heart.2 Sometimes small blockages build up inside your blood vessels. These blockages are called plaque. They develop when cholesterol sticks to the wall of the artery. Your immune system, sensing a problem, will send white blood cells to attack the cholesterol. This sets off a chain of reactions that leads to inflammation. In a worst-case scenario, cells form a plaque over the cholesterol, and a small blockage is formed. Sometimes they can break loose and cause a heart attack. As the plaques grow, they may block blood flow in an artery entirely. This blocked blood flow to the lower extremities is effectively Peripheral Artery Disease (PAD).

What Can You Do to Unclog Arteries?

Peripheral artery disease doesn’t always require a procedure. There are lifestyle changes and medications that can help promote healthy arteries. Here are some ways you can promote healthy arteries:

Consult with your primary care physician before starting any new diet or workout routines. Defer to your doctor to evaluate potential concerns and to make the referral to a vascular partner. Our goal is to promote Peripheral Artery Disease awareness, its risk factors, and treatment options. With more awareness, patients and doctors will be able to identify early signs of PAD and ensure early intervention in order to decrease these numbers. Modern Vascular treats PAD through a non-invasive outpatient clinic setting. To learn more about our clinics,  PAD, and PAD-related problems, or you are searching for the right vascular partner for your procedure, call Modern Vascular (888) 853-1278 or use our online form to schedule your consultation today.


  1. Frothingham, Scott. Artery vs. Vein: What’s the Difference?,, 12 Apr. 2018,
  2. Hochauf, Sandra; Sternitzky, Reinhardt; Schellong, Sebastian M. (2007). “Struktur und Funktion des venösen Systems”. Herz (in German). Springer Nature. 32 (1): 3–9.
  3. Gilvydis, Rimas. “THE DIFFERENCE BETWEEN VEINS AND ARTERIES.”, Northern Illinois Vein Clinic, 23 July 2019,
  4. “Arterial (Artery) Disease.” Arterial (Artery) Disease | Frankel Cardiovascular Center | Michigan Medicine,
  5. Seladi-Schulman, Jill. Arteries of the Body, 26 Feb. 2019,
  6. Holland, Kimberly. Is It Possible to Unclog Your Arteries?, 17 Sept. 2019,
Modern Vascular The Importance of Wound Care - Diabetic Foot Ulcers -Southaven, MS

The Importance of Wound Care

A common warning sign of Peripheral Artery Disease (PAD) is an ulcer or a wound that is slow to heal on the feet or legs. When sores or wounds do not get enough blood it can affect your body’s ability to heal the wound and increases the risk of infection. This is why patients with poor circulation due to PAD often need special care in order to heal a wound.

Wound Assessment

Wounds are described as either acute or chronic. A chronic wound is a wound that has failed to heal in 4-6 weeks and does not move through the normal stages of healing.  When wounds fail to heal, they can result in pain, infection, and can lead to amputation.  In addition, chronic wounds can lead to loss of workdays and lost income.5

Wounds can have many different causes and multiple influences. Therefore, when choosing the right plan of care it is important that all factors that contribute to wound healing are taken care of. In other words, do not just address the wound itself, but underlying infection, nutrition, and specific patient lifestyle factors which should be considered to optimize wound healing.

PAD & Chronic Wounds

Patients with underlying PAD are at increased risk of developing nonhealing wounds and ulcers and have a higher rate of amputation. Therefore, it is important for people that have PAD to seek out wound care. Here are some common wounds that occur in patients with Peripheral Artery Disease.

Arterial Ulcers

Arterial ulcers are caused by blockages in the arteries that are responsible for delivering oxygenated blood to the lower extremities. This leads to tissue damage and a state of ischemia, as the tissue lacks the necessary oxygen for healing. These wounds or ulcers typically have a “punched out” appearance and are well-circumscribed with pale pink, gray, or yellow appearance. The ulcers may be located between or on the tips of the toes or in the lower leg and are typically full-thickness.3

Diabetic (Neuropathic) Foot Ulcers

These foot ulcers are the result of the loss of peripheral sensation, often seen in patients with diabetes. This loss of sensation causes extended microtrauma, leading to the breakdown of overlying tissue, and the eventual formation of an ulcer.4 The ulcer may not be painful due to lack of sensation, and often occurs at pressure points, including the plantar aspect of the foot.  These ulcers tend to be round, with calloused edges and a partial- or full-thickness, and with a pale or pink appearance.

Watch this video to learn about the link between diabetes and peripheral artery disease:

Dr. Scott Brannan talks about how diabetes contributes to peripheral artery disease and neuropathy.

Causes and Risk Factors

In addition to PAD and vascular insufficiency, common contributing causes of chronic wounds include diabetes mellitus, renal failure, trauma, foot deformity, callus formation, limited joint mobility, and smoking history.

Unique risk factors for neuropathic ulcers include primary neurological conditions, alcohol-related neuropathy, spinal abnormalities, trauma, or surgery. Treatment includes managing foot care, debriding the wound, and reducing the pressure on the affected area. Amputation may become necessary in severe cases. At-risk patients should take precautions to control their diabetes, inspect their feet daily, and ensure they have proper footwear.3

Wound Care & PAD Treatment

Patients with underlying PAD and a chronic wound can help prevent serious complications by seeking treatment in the early stages of the wound, to help identify and treat both the PAD as well as other factors which may be impacting wound healing.  Exercising, eating properly, avoiding tobacco, and managing any underlying conditions — such as diabetes or high blood pressure, or cholesterol — can help prevent PAD from developing or progressing.

Treatment for arterial ulcers focuses on the restoration of adequate circulation, usually via minimally invasive, or endovascular techniques or less often with surgical revascularization.  All patients with PAD and ulceration are advised to control medical factors including diabetes, hypertension, and cholesterol, optimize nutrition, and stop smoking to promote a healthy wound environment and expedite healing after revascularization.  A comprehensive approach to wound healing with PAD can help prevent amputation and save lives.

Learn More about Modern Vascular’s commitment to Wound Care.

See all of our Wound Care videos


  1. Myers, B (2008). Wound Management: Principles and Practice. (2nd Edition). Pearson Prentice Hall. Upper Saddle River, New Jersey.
  2. Worley, C (2004). Why won’t this wound heal? Factors affecting wound repair. Dermatology Nursing. Downloaded from the web January 18,
  3. Cleveland Clinic. Lower Extremity (Leg and Foot) Ulcers. Cleveland Clinic. Published August 17, 2017. Accessed March 28, 2019
  4. Salcido R. Pressure Ulcers and Wound Care. Medscape Reference. Updated June 11, 2018. Accessed March 28, 2019.
  5. 2011 Spear, M. (2013). Acute or chronic? What’s the difference? Plastic Surgical Nursing, 33(2); pg. 98-100. Downloaded February 10, 2013.…
Smoking and the blood vessels

How Smoking Affects the Blood Vessels

The health risks associated with smoking are often regarded as common knowledge, which is why roughly 70 percent of American smokers want to quit. Unfortunately, according to a recent government study, only 6 percent succeed 1. Although damage to the lungs is common knowledge, many have no idea that smoking is also bad for their blood vessels and is among the many causes of peripheral artery disease (PAD).

The chemicals in tobacco detrimentally affect how the heart and blood vessels function. This can increase your risk of developing atherosclerosis, a condition in which plaque builds up in the arteries. Over time, plaque can harden and cause your arteries to narrow, limiting the flow of oxygen-rich blood to your organs and other parts of your body.2

Smoking and Peripheral Artery Disease

There is a very strong connection between smoking and peripheral artery disease (PAD). Reportedly, smoking half a pack of cigarettes a day may increase your risk of having PAD by up to 50 percent.4 Additionally, about 90 percent of patients with PAD have a history of smoking.3

Most smokers learn about the impact that smoking has on the lower extremities when a physician diagnoses them with PAD. Any amount of smoking, even occasionally, damages the heart and blood vessels. Secondhand smoke also can hurt the heart and blood vessels, greatly increasing the risk of heart attack and death in adults.3

Why You Should Quit Smoking

Considering the risks and how so many smokers who actually want to quit face challenges, it is incredibly important to quit smoking. Smoking increases the risk of PAD by up to six times and makes the symptoms worse. 5 Initiatives like Take Down Tobacco National Day of Action help encourage smokers to kick the habit.


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By quitting smoking, PAD patients can increase their chances of long-term survival. In fact, one study found that 82 percent of former smokers were still alive after 10 years, compared with only 46 percent of patients who continued smoking.3

Regardless of how much or how long you’ve smoked, quitting has a variety of benefits, including reducing your risk of developing heart disease, having a stroke, lowering your risk of atherosclerosis, blood clots, and PAD. 2

Tips for Quitting Smoking

Quitting smoking is truly a journey, not just a single event that happens on one day. In order to quit, you will have to put the prospect of improving your health, and the quality and duration of your life as your focus.

With the right plan, your journey will be off on the right step with some of the following ways one can begin the quitting journey. Here are five ways to tackle smoking cessation:

  • Prepare for the Quit Day.
  • Know your triggers and avoid them early on.
  • Know that the first few days are the toughest.
  • Don’t give in to your cravings.
  • Try a new hobby with friends who don’t smoke.


  1. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Reports (MMWR)Quitting Smoking Among Adults (accessed 3/12, 2021)
  2. National Heart, Lung, and Blood Institute. Smoking and your heart. (accessed March 12, 2021)
  3. Lu JT, Creager MA. The relationship of cigarette smoking to peripheral arterial disease. Rev Cardiovasc Med. 2004 Fall;5(4):189-93. Review. PubMed PMID: 15580157. (accessed March 12, 2021)
  4. Vascular Disease Foundation. Life Saving Tips About… Smoking and PAD (accessed March 12, 2021)
  5. Centers for Disease Control and Prevention. Peripheral Arterial Disease (PAD) Fact Sheet (accessed March 12, 2021)
Just a little walking may help prevent a PAD procedure

Walking Program: Benefits & Tips

Before starting any exercise program make sure to speak with your doctor. They can assist you with a structured walking program either through a physical therapy program or simply walking on a treadmill, around the mall or grocery store, or in your neighborhood.

Walking exercises the muscles in the calves, thighs, and buttocks. These are large muscle groups that have a high level of oxygen demand. When you are walking, the oxygen demand of those muscles increases. Chemical messengers are sent to the blood vessels to tell the smooth muscle in the lining of the arterial wall to relax, open up, and allow more blood flow. That improves the blood flow to everything below the waist when you are walking. Also, it encourages new connections between the microvessels.

Cardiovascular fitness helps your body deliver blood carrying oxygen and nutrients to your most important organs, including your heart and your brain. Studies show that it can help improve your cognition, memory, mood, and sleep. It can also help alleviate stress, increase energy levels, strengthen your bones, and lose body fat.

Getting Started With a Walking Program

It is a great idea to plan ahead if you are struggling with your walking routine. Keep track of how long you can walk and how far you can get. As you progress you should be able to walk for longer periods of time and greater distances.

Structured Walking Program Example

  • Warm up with light stretching of your calf and thigh muscles.
  • Start walking at a pace that is fast enough that you may have slight discomfort.
  • Stop and rest until that discomfort or pain goes away.
  • Repeat this routine several times slowly building up your walking time, about 3 to 5 times a week.
  • Cool down. Slowly walk for 5 minutes followed by light stretching of your calf and thigh muscles.

Do You Have Pain or Cramping When You Walk?

Have you noticed that you choose to walk less and park closer to stores because walking causes you discomfort? Do you wake up at night because your legs hurt? Do you use a cane, walker, or scooter to assist you with mobility because your legs feel weak?

You Might Have PAD

What is PAD, you ask? PAD, which stands for peripheral artery disease, is caused by cholesterol and other fatty substances that block the blood vessels going to your lower legs and into the feet. Due to the decreased blood flow to the muscles and other tissues, it is common to experience pain and cramping. It is frequently seen in people over the age of 50, people who have smoked or still do, people living with diabetes, people experiencing diabetic neuropathy (nerve damage which causes numbness, tingling, and pain), or people that have high blood pressure.

Other indicators for PAD include wounds or ulcers on the legs or feet that do not heal in an appropriate amount of time. Also, if the skin is discolored or if the hair is growing at a slower rate, that could indicate that you may be at risk. If you are experiencing any of these symptoms you are advised to talk to your primary care physician.

Does Walking Help Peripheral Artery Disease?

If you are experiencing the symptoms of PAD, a structured walking program can help. Weight-bearing exercise works by improving your circulation through the growth of new blood vessels. Those vessels can help ease the pain but it does not happen overnight, just like your PAD did not happen overnight. A walking program is beneficial to all PAD-affected patients but especially to those pre-symptomatic patients and those already treated for PAD through revascularization procedures, like those done at Modern Vascular.

Walking is a simple form of exercise that isn’t too intense. It is great for slowly increasing physical activity because it is easy to start and stop. If you are experiencing pain when you are walking you should try to rest until the pain subsides before you continue to walk. As we had mentioned before, it is good for cardiovascular fitness. Improving cardiovascular fitness can improve the severity of the symptoms. When you are trying to introduce more physical activity into your routine to improve health conditions that you may have you should consult with a doctor to make sure that it is not causing more harm to the parts of the body that are experiencing pain.

Exercise Guidelines For Patients With PAD

The American Heart Association studied the optimal exercise routines for patients that are suffering from peripheral artery disease. Accordingly, they are able to offer recommendations to patients with lower-extremity PAD. These are the PAD exercise guidelines that are available from their study.

  • An exercise program with supervision is recommended for patients that have claudication.
  • Before possible revascularization, a walking program should be discussed.
  • An exercise program and behavioral changes can help improve the ability to walk and functional status in patients that have peripheral artery disease.
  • Different exercise strategies like cycling, upper-body ergometry, and low-intensity walking that don’t get to the level of moderate or maximum claudication can be beneficial.

There is evidence that supports exercise as a means to improve the condition of peripheral artery disease that goes all the way back to 1966. There has been a number of clinical trials since then that continue to support that evidence. Most of the studies conducted on PAD walking performance used treadmills, so treadmills can be considered a good tool to use for a PAD walking program.

Please consult with a doctor if you think that you have peripheral artery disease. Do not over-exert yourself if you are experiencing PAD symptoms without first speaking to a doctor. To determine if you may be at risk for peripheral artery disease, you can take the Modern Vascular PAD Risk Assessment Quiz.

How heart health and vascular health are related Modern Vascular Blog

Listen to Your Heart: Vascular Health

Imagine that your body is a machine and your heart is the pump that keeps it running. Now, consider how your body lets your heart know that your vascular system isn’t running at its best.

Soreness and intermittent cramps are a key symptom of Peripheral Artery Disease (PAD). A burning or aching feeling in your feet or toes may also indicate PAD. These are signs of insufficient blood flow and potential heart problems.

Improving Your Vascular Health

You may already be taking medicines to ease leg pain or to help you manage other health problems. If you have these symptoms and have not been evaluated you should talk to your doctor to figure out what’s wrong and fix it. It is important to address any issues as they come up with any machine, no matter how well-designed it may be.

Healthy Lifestyle Choices

It’s important to do what you can to improve your heart health and possibly reverse the buildup of plaque in your arteries. PAD comes with a high risk of heart attack, stroke, or limb amputation. Making healthy changes today and following a treatment plan can reduce this risk. Here’s how you can get started:

  • Quit smoking and the use of tobacco products.
  • Be active! Try walking, swimming, or biking for at least 30 minutes a day.
  • Eat heart-healthy foods such as fruits, nuts and vegetables.
  • Maintain a healthy weight.


There are medications proven to help prevent blood clots, lower cholesterol, and lower blood pressure. However, these medicines are not a replacement for healthy lifestyle choices. Of course, medications are great non-surgical options for lowering your risk of heart attack and stroke.

You should always consult with a doctor when using medication to treat symptoms. If medication and a healthy lifestyle alone is not reducing the risks associated with PAD, you might need to explore other options that are available.

American Heart Health Month: How Coronary Artery Disease and PAD are related
February is American Heart Month. Find out how Coronary Artery Disease and Peripheral Artery Disease are related.

Minimally Invasive Surgery and Catheter-Based Procedures

Sometimes Peripheral Artery Disease requires advanced treatments. If you have severe PAD you may require a minimally invasive procedure to restore proper blood flow to the legs. If you think that you have Peripheral Artery Disease and want to know what course of treatment is best for you then it would be beneficial to get evaluated for PAD. Ultimately, your vascular health is very important and it is wise to make sure your body is working as intended.

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