Noninvasive Vascular Diagnosis

478 Pages·2000·84.888 MB·English

by  Anne M. Jones (auth.), Ali F. AbuRahma MD, RVT, John J. Bergan MD (eds.)

N oninvasive Vascular Diagnosis
Springer-Verlag London Ltd.
Ali F. AbuRahma and John J. Bergan (Eds)
Noninvasive
Vascular Diagnosis
Foreword by Robert B. Rutherford
With 315 figures, 72 in colour
, Springer
Ali F. AbuRahma, MD, RVT
Professor of Surgery, Chief ofVascular Surgery, and Medical Director ofVascular Laboratory,
Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, West Virginia,
USA
John J. Bergan, MD
Professor of Surgery, North Co ast Surgeons, 9850 Genessee Avenue, Suite 560, La Jolla,
California, CA 92037, USA
ISBN 978-1-4471-3839-6 ISBN 978-1-4471-3837-2 (eBook)
DOI 10.1007/978-1-4471-3837-2
British Library Cataloguing in Publication Data
Noninvasive vascular diagnosis
1. Blood-vessels - Diseases - Diagnosis 2. Diagnosis, Noninvasive
1. AbuRahma, Ali F. 1I. Bergan, John J.
616.1'3'0754
Library of Congress Cataloging-in-Publication Data
Noninvasive vascular diagnosis/ Ali F. AbuRahma and John J. Bergan, eds.
p. cm.
Includes bibliographieal references and index.
1. Blood-vessels - Diseases -Diagnosis. 2. Diagnosis, Noninvasive.
3. Blood vessels - Ultrasonie imaging. 1. AbuRahma, Ali F.
1I. Bergan, John J., 1927-
[DNLM: 1. Vascular Diseases - diagnosis. 2. Ultrasonography - methods.
3. Angiography - methods. 4. Plethysmography - methods.
5. Magnetic Resonance Imaging - methods. WG 500 N813 1999]
RC691.6.N65N6671999
616.1'3075 - dc21
DNLM/DLC
For Library of Congress 98-50138
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the
Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or
by any means, with the prior permission in writing of the publishers, or in the case of reprographie reproduction in
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© Springer-Verlag London 2000
Originally published by Springer-Verlag London Berlin Heidelberg in 2000
Softcover reprint ofthe hardcover 1st edition 2000
The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific
statement, that such names are exempt from the relevant laws and regulations and therefore free for general use.
Product liability: The publisher can give no guarantee for information about drug dosage and application thereof
contained in this book. In every individual case the respective user must check its accuracy by consulting other
pharmaceutiealliterature.
Typeset by EXPO Holdings, Kuala Lumpur, Malaysia
28/3830-543210 Printed on acid-free paper SPIN 10689806
To my loving family: My wife, Marion, and my children, Zachary, Chelsea and Joseph, for their
patience and support during preparation of this book
Ali F. AbuRahma
To my lovely wife and to our good friend R.ß.
lohn Bergan
Foreword
T
his book is remarkable when compared with books concerning the vascular diagnostie
laboratory of a few years ago, one of whieh Dr. AbuRahma co-authored. At the present
time, noninvasive diagnosis is dominated by duplex scanning and other imaging modalities.
Physiologie studies are being down-played. This is due to the increasing dominance of the
field by radiology-based laboratories. Therefore it is a pleasure to see this book whieh
covers both imaging and physiologie studies well, and does so in a problem-oriented
format.
This volume does more than that. It addresses the full gamut of vascular laboratory opera
tions including accreditation of laboratories and its personnei; it covers the basic physies of
ultrasound instrumentation; and it treats thoroughly each of the four important component of
vascular laboratory accreditation: cerebrovascular, peripheral arterial, venous and abdominal
studies. The book also deals with a number of special areas whieh are peripheral to most vas
cular diagnostie laboratories but are included in their operations by some - three-dimensional
imaging, intravascular ultrasound, magnetie resonance angiography and Doppler fiow wire to
name just a few. This breadth of coverage has not been seen since the mammoth volumes of a
decade ago that the late Gene Bernstein published as proceedings of his San Diego meetings.
But this book differs from those volumes in that it is not a compendium of focused presenta
tion for a meeting. It is instead a carefully organized comprehensive coverage of everything
one would need to know and could expect to encounter in the most complete vascular labora
tory operation conceivable. For example, the section on cerebrovascular diagnosis not only
includes overviews of clinieal considerations and the various techniques, it provides individ
ual chapters on carotid duplex examination, evaluation of proximal aortic arch vessels, exami
nation of the vertebral arteries and even describes use of the transcranial Doppler. This then
ends up with a clinieal correlation chapter that critiques these competitive techniques and
discusses their relative value in specific clinieal settings. The intraoperative assessment of
technieal adequacy of carotid endarterectomy is described, for example; then the survey of a
patient developing neurologie deficits after operation is addressed; the postoperative sur
veillance after endarterectomy or angioplasty is detailed; the laboratory evaluation of the
trauma vietim is included; and examination of the patient presenting with vertebro
basilar symptoms is explained. Each major section has a final chapter such as this whieh
brings all the preceding information together in a practieal and meaningful summary for the
clinician.
As organized, this book is ideal for any physician of any specialty background, whether in
training or in practice, who wants current and in-depth coverage of noninvasive vascular diag
nosis from operations and administration, to credentialing, to fundamental techniques and
their instrumentation or specific clinieal applieations in every conceivable setting.
11
viii Foreword
The authors are to be commended for putting together such a comprehensive text at this
time of need to hold all the components of noninvasive diagnosis together as a tradition al
vascular diagnostic laboratory. The reader will benefit from their vision and from efforts of
their well-selected contributing authors.
Robert B. Rutherford, MD
Emeritus Professor of Surgery
University of Colorado
Acknowledgments
T
hiS book owes much to our colleagues, who have contributed a great deal to the text. Their
particular interests and expertise add substance to this volume. Without exception, they
managed to submit intelligent and up-to-date contributions.
This volume survived thanks to the support of our technical staff, particularly Mona Lett in
Charleston for transcribing and revising the many versions of several of the chapters and for
maintaining contact with contributing authors regarding guidelines and deadlines. In
California, Monica Vickers contributed good humor and transcription expertise.
Our profound appreciation goes to Matthew Mills and Maynard Chapman for producing
the majority of the illustrations used in this book. We are most grateful for the efforts of Susan
Chidress and Julie Hudson in contacting contributing authors and copying chapters. We
appreciate the efforts of the Vascular Laboratory staff in Charleston, West Virginia - Leigh
Cutlip, Stephanie Alberts, and Kim Jarrett - for assistance in providing some of the illustra
tions for this book.
The Springer-Verlag publishing team and Nick Mowat in England recognized the worth of
this project. Christopher Greenwell gave invaluable assistance and, in demonstration of the
fact that the internet brings us all together, Susan Parmentier acted as technical editor from
her office in Evanston, Illinois. Without the support of those named here, and many others,
this volume could not have seen the light of day.
Ali F. AbuRahma
John J. Bergan
Contents
List of Contributors ....................................... XIV
I. VASCULAR LABORATORY OPERATIONS
1. Training and Certification ofVascular Technologists
Anne M. Iones .................... . 3
2. Accreditation ofNoninvasive Vascular Laboratories
I. Dennis Baker . . . . . . . . . . . . . . . . . . . . . 11
3. Qualifications of the Physician in the Vascular Diagnostic Laboratory
Michael A. Ricci and Robert B. Rutherford . . . . . . . . . . . . . . . . 19
11. BASIC PHYSICS
4. Principles and Instruments of Diagnostic Ultrasound and Doppler Ultrasound
Kirk Beach, ling-Ming long, Marla Paun and lean F. Primozich ......... 25
111. NONINVASIVE CEREBROVASCULAR DIAGNOSIS
5. Overview of Cerebrovascular Disease
Ali F. AbuRahma and Daniel L. Stickler ...... . 51
6. Overview ofVarious Noninvasive Cerebrovascular Techniques
Ali F. AbuRahma . . . . . . . . . . . . . . . . . . . . . . . . . . 69
7. Duplex Scanning of the Carotid Arteries
Ali F. AbuRahma . . . . . . . . . . . . . . 91
8. The Role of Color Duplex Scanning in Diagnosing Diseases of the Aortic
Arch Branches and Carotid Arteries
Ali F. AbuRahma ................................... 119
9. Vertebral Artery Ultrasonography
Gerhard-Michael von Reutern and Alfred V. Persson ............... 127
10. Transcranial Doppler Sonography
Andrei V. Alexandrov and lohn w. Norris .......... 135
11. Duplex Ultrasound Detection of Carotid Plaque Morphology
Linda M. Reilly .................................... 155