Guidelines for noninvasive vascular laboratory testing: a report from the American Society of Echocardiography and the Society for Vascular Medicine and Biology.
Accompanying the rapid growth of interest in percutaneous vascular interventions, there has been increasing interest among cardiologists in performing noninvasive vascular testing using ultrasound. In an attempt to provide recommendations on the best practices in vascular laboratory testing, this report has been prepared by a writing group from the American Society of Echocardiography (ASE) and the Society for Vascular Medicine and Biology. The document summarizes principles integral to vascular duplex ultrasound--including color Doppler, spectral Doppler waveform analysis, power Doppler, and the use of contrast. Appropriate indications and interpretation of carotid artery, renal artery, abdominal aorta, and peripheral artery ultrasound imaging are described. A dedicated section summarizes noninvasive techniques for physiologic vascular testing of the lower extremity arteries--including measurement of segmental pressures and pulse volume plethysmography. The use of exercise testing in the evaluation of peripheral artery disease, ultrasound evaluation of the lower extremities after percutaneous revascularization, and the diagnosis and management of iatrogenic pseudoaneurysm (PSA) is also discussed. A section on the important topic of vascular laboratory accreditation is included. Finally, additional details regarding proper technique for performance of the various vascular tests and procedures are included in the Appendix.
Gerhard-Herman
Marie
M
Brigham and Women's Hospital, Boston, MA 02115, USA. mgerhard@partners.org
Gardin
Julius M
JM
Jaff
Michael
M
Mohler
Emile
E
Roman
Mary
M
Naqvi
Tasneem Z
TZ
D000068:Accreditation; D017541:Aneurysm, False / Q000000981:diagnostic imaging; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging; D001158:Arteries / Q000000981:diagnostic imaging; D001794:Blood Pressure; D002309:Cardiology / Q000193:education / Q000379:methods*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003479:Curriculum; D004503:Education, Medical, Graduate; D005080:Exercise Test; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007349:Insurance, Health, Reimbursement; D035002:Lower Extremity / Q000098:blood supply*; D006278:Medicare / Q000191:economics; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D010991:Plethysmography; D011674:Pulse; D012077:Renal Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional / Q000191:economics / Q000379:methods*; D014481:United States; D014656:Vascular Surgical Procedures