Vascular Diagnostics: Noninvasive and Invasive Techniques Periinterventional Evaluations PDF
Preview Vascular Diagnostics: Noninvasive and Invasive Techniques Periinterventional Evaluations
P. Lanzer 1. Rosch (Eds.) Vascular Diagnostics Noninvasive and Invasive Techniques Periinterventional Evaluations Foreword by W W Parmley and G. Schettler With Contributions by C. J. G. Bakker, R. E. Barton, G. Biamino, P. Bosinger, E. G. Cape, J. Carreira, L. E. Crooks, P. de Jaegere, C. M. Gross, E. Gussenhoven, K. Haag, M. J. Hartkamp, J. Haase, D. Hausmann, M. Hennerici, J. Hennig, J. B. Hermiller, R. T. Higaschida, N. Hylton, D. Keane, F. S. Keller, M. Kouwenhoven, W. Krause, P. C. Lakin, P. Lanzer, W. Li, W. Marz, w. P. Th. M. Mali, M. R. Malinow, M. Maynar, K. Mizuno, G. L. Moneta, M. Nauck, J. Niepel, J. Noordzij, C. M. Orr, T. Peters, H. Pieterman, C. A. Pinkerton, L. J. Polman, J. M. Porter, J. M. Pulido-Duque, W. Rautenberg, H. Refsum, N. Reifart, R. Reyes, J. Rosch, P. J. Rubio, R. R. Saxon, M. Scheidegger, P. W. Serruys, W. Steinke, B. H. Strauss, G. P. Teitelbaum, S. H. K. The, P. M. Ueland, V. A. W. M. Umans, A. van der Lugt, F. C. van Egmond, M. S. van Leeuwen, J. van Tassel, H. van Urk, B. Velthuis, I. Wendelhag, K. U. Wentz, H. Wieland, J. Wikstrand, P. G. Yock, A. P. Yoganathan, E. Zeitler Springer Dr. Peter Lanzer Kardiologische Gemeinschaftspraxis SaalbaustraBe 27 D-64283 Darmstadt, FRG Prof. Dr. Josef Rosch Oregon Health Sciences University Charles Dotter Institute of Interventional Therapy 3181 S.w. Sam Jackson Park Road Portland, Oregon 97201-3098 USA ISBN-13:978-3-642-78961-8 e-ISBN-13:978-3-642-78959-5 DOl: 10.1007/978-3-642-78959-5 Library of Congress Cataloging-in-Publication Data. Vascular diagnostics: noninvasive and invasive techniques: periinter ventional evaluations 1 P. Lanzer, J. Rosch (eds.). p. cm. Includes bibliographical references and index. ISBN-13:978-3-642-7896l-8 1. Blood-vessels-Diseases-Diagnosis. I. Lanzer, P. (Peter), 1950- . II. Rosch, J. (Josef), 1925- . [DNLM: 1. Vascular Diseases-diagnosis. 2. Diagnostic Imaging. WG 500 V33125 1994] RC691.5. V37 1994 616.1'30754-dc20 DNLMlDLC This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitating, broadcast-ing, reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright of this publication of parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its current version, and a copyright fee must always be paid. Violations fall under the prosecu tion act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1994 Softcover reprint of the hardcover 1st edition 1994 The use of registered names, trademarks, etc. in this publication does not imply, even in the absende of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Produkt Liability: The publishers can give no guarantee for information about drug dosage and applications thereof con tained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Production and Supervision: W. Bischoff, Heidelberg Cover Design: E. Kirchner, Heidelberg Reproduction of Figures and 'JYpesetting: Mitterweger Werksatz GmbH, Plankstadt 23/3130 - 5 4 3 2 1 0 - Printed on acid-free paper Foreword Vascular disease is the number one cause of mobidity and mortality in developed countries. Although diagnostic techniques have been available for decades to assess the severity of vascular disease, there has been a recent development of new techniques and new applica tions of old techniques which have greatly enhanced our ability to characterize the ana tomic location and severity of vascular involvement. This textbook on vascular diagnostics performs a great service for the clinician dealing with vascular disease by bringing together in one volume excellent multiauthor reviews of the most important techniques available for vascular evaluation. There is particular emphasis on newer techniques and the additional information which they can provide. Those who deal with the coronary circulation, the ce rebral circulation, and the rest of the peripheral circulation will find this an important col lection of critical reviews of the field. In expressing enthusiasm for newer diagnostic techni ques, however, the authors have not neglected the basic fundamentals of the physical ex amination, basic laboratory examinations, and evaluation of lipoprotein metabolism. I be lieve that the reader will be rewarded for the time spent in reviewing specific chapters of in terest or, more importantly, gaining an overview of a field which is under continuing, rapid development. A glance at the international authorship of this book reveals some of the most well-known researchers in their respective areas. Thus this book is authoritative and relatively comprehensive for its size in providing the reader with a current snapshot of the ever-changing arena of vascular diagnostics. It is a much needed and welcome addition to the library of cardiologists, neurologists, radiologists, vascular surgeons, and others. William W. Parmley Foreword The textbook provides a long awaited interdisciplinary perspective of the state-of-the-art vascular diagnostics. The editors have succeeded in presenting the reader with a compre hensive and authoritative review of the noninvasive and invasive diagnostic methods util ized to assess cerebrovascular, coronary and peripheral vascular disease. The individual chapters are written by competent, internationally recognized vascular specialists. The style is clear, definitive and critical. The sections on metabolic and periinterventional evaluations employed in preventive and interventional vascular medicine are appropriately emphasized and to the specializing as well as the general reader of particular interest. The sections on new upcomming vascular diagnostic methodologies are informative and com plete. I wish to compliment the editors, the authors and the publishers for providing the readers with an outstanding textbook and with the much needed information on modern means and ways to evaluate vascular patients. I hope that "Vascular Diagnostics" will be widely read and consulted not only in the english but also in german speaking medical commun ities. Gerhard Schettler Preface Modern vascular diagnostics is a complex, interdisciplinary enterprise. Recognizing the no sologic unity of the vascular organs as well as the systemic character of vascular pathogene sis, this area spans a wide range of metabolic, functional, and morphologic diagnostic measure. The textbook Vascular Diagnostics has been designed to provide an interdisciplinary per spective of the clinically applicable noninvasive and invasive diagnostic evaluations of the cerebral, coronary, visceral, and peripheral vasculature, and where appropriate, of the cor responding vascular-related end-organ functions. Due to the growing importance of pre vention and intervention in vascular medicine, the metabolic and periinterventional tech niques have been strongly emphasized. To avoid repetition, standard examination tech niques have not been systematically reviewed in this context. We have chosen to preview the most promising vascular imaging technologies, whereas we felt that inclusion of upcoming hemostaseologic, immunologic, and molecular biologic vascular diagnostic tech niques in this volume would have been premature. The textbook is divided into three parts and nine sections based on the noninvasive or in vasive nature of the individual diagnostic technique and on the specific vascular territory in question. Each diagnostic method is discussed under individualized headings, allowing the reader both a systematic and a random review of the topics presented. The text advances from noninstrumentel to instrumental nonimaging, noninvasive imaging, and invasive im aging diagnostic strategies. Parts I and II are devoted to current clinical methods, and in Part III upcoming imaging technology is discussed. Quite obviously, a properly conducted physical examination still retains its importance in selecting the most efficient vascular diagnostic cascade. Among the nonivasive techniques, vascular ultrasound has become the primary method in the initial and follow-up assessment of vascular disease in nearly all major vascular territories. Clinical ultrasonographic ap plications pertinent to the individual vascular territories are extensively discussed and re viewed. The clinical importance of invasive methods, i.e., angiography and venography, has been reduced as far as the purely diagnostic evaluations are concerned, reflecting the wide availability and excellence of vascular ultrasonography. On the other hand, their value has markedly increased as a primary tool in periinterventional settings. Here in par ticular, the predominant role of computer-enhanced angiography has been highlighted. The present clinical role of these radiographic techniques and their direct impact on interven tional therapy has been assessed and evaluated. In the final sections of the textbook, the search for better noninvasive and more advanced invasive visualization of the vascular sys tem is documented. We hope that the textbook will provide professionals in the field with a useful guide to modern vascular diagnostics and foster the much-needed interdisciplinary approach to vas cular care. We wish to thank all our colleagues and co-authors, as well as the staff of Springer-Verlag in Heidelberg, especially Dr. V. Gebhardt and Mr. W. Bischoff, for making this project possible. Peter Lanzer Josef Rosch Contents Part I: Noninvasive Techniques Section I: General Vascular Diagnostics Vascular Physical Examination P. Lanzer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 3 Laboratory Examinations A. Fronek . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 19 Section II: Metabolic Vascular Diagnostics Diagnostics of Lipids and Lipoproteins H. Wieland, W. Marz, and M. Nauck .... . . . . . . . . . . . . . . . . . . . . . . . . . .. 33 Diagnostics of Homocysteine Metabolism P. M. Ueland, H. Refsum, and M. R. Malinow. . . . . . . . . . . . . . . . . . . . . . . .. 75 Section III: Vascular Ultrasonography Imaging Technology E. G. Cape and A. P. Yoganathan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 87 Cerebrovascular Ultrasonography W. Steinke, W. Rautenberg, and M. Hennerici . . . . . . . . . . . . . . . . . . . . . . . .. 97 Quantitative Ultrasonography of Carotid and Femoral Arteries J. Wikstrand and I. Wendelhag. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Abdominal and Pelvic Vascular Ultrasonography K. Haag and P. Lanzer ......................................... 139 Peripheral Vascular Ultrasonography G. L. Moneta and J. M. Porter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Part II: Invasive Techniques in Periinterventional Evaluations Section I: Radiographic Angiography Imaging Technology J. Niepel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 XII Contents Angiographic Contrast Agents Wo Krause 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Cerebrovascular Angiography Go Po Teitelbaum and Ro T. Higashida 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Coronary Angiography J Haase and No Reifart 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Quantitative and Qualitative Coronary Angiography Jo Bo Hermiller, Eo T. Fry, T. Peters, Co Mo Orr, Jo van Tassel, and Co Ao Pinkerton 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Quantitative Coronary Angiography in Interventional Cardiology V. Ao Wo Mo Umans, Bo Ho Strauss, Do Keane, Jo Haase, Po de Jaegere, and Po Wo Serruys 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Thoracic and Upper Extremity Arteriography R. Reyes, Jo Mo Pulido-Duque, Eo Gorriz, P. Jo Rubio, Jo Carreira, Co Gerv:is, and Mo Maynar 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Abdominal Arteriography R. Ro Saxon, Ro Eo Barton, Jo Rosch, and F. So Keller 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Peripheral Angiography Eo Zeitler 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Section II: Radiographic Venography Central and Peripheral Venography Po C. Lakin and Jo Rosch 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Part III: Work.in.Progress Section I: Vascular Magnetic Resonance MR Principles and Technology L. Eo Crooks and No Mo Hylton 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MR Angiographic Imaging Mo Kouwenhoven, Co Jo Go Bakker, Mo Jo Hartkamp, and W. Po Tho Mo Mali 375 0 0 0 0 0 Cerebrovascular MR Imaging Jo Hennig and K. U. Wentz 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Coronary MR Imaging Mo Bo Scheidegger and Po Boesiger 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Peripheral Vascular MR Imaging Mo Jo Hartkamp, Co Jo Go Bakker, Mo Kouvenhoven, and W. Po Tho Mo Mali 421 0 0 0 0 0 0 Contents XIII Section II: Computed Tomography Computed Tomographic Angiography M. S. van Leeuwen, L. J. Polman, J. Noordzij, and B. Velthuis .............. 443 Section III: Intravascular Ultrasound Coronary Intravascular Ultrasonography D. Hausmann, P. J. Fitzgerald, and P. G. Yock ......................... 465 Peripheral Intravascular Ultrasonography E. J. Gussenhoven, A. van der Lugt, S. H. K. The, W. Li, F. C. van Egmond, H. Pieterman, and H. van Urk ................................... 481 Section IV: Angioscopy Coronary Angioscopy K. Mizuno. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493 Peripheral Angioscopy c. M. Gross and G. Biamino ..................................... 509 Subject Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 523 List of Contributors C. J. G. Bakker L.E. Crooks Department of Radiology University of California, San Francisco University Hospital Utrecht (E 01.132) UCSF Radiologic Imaging Laboratory Heidelberglaan 400 Grandview Drive 3584 CX Utrecht South San Francisco, CA 94080 The Netherlands USA R. E. Barton P. de J aegere Oregon Health Sciences University Catheterization Laboratory School of Medicine Thoraxcenter Bd 414 Charles Dotter Institute of Interventional P.O. Box 1738 Therapy 3000 DR Rotterdam 3181 S. W. Sam Jackson Park Road, L605 The Netherlands Portland, OR 97201-3098 USA P. J. Fitzgerald G. Biamino Stanford University Medical Center Abt. fur Klinische und Center for Research in Interventionelle Angiologie Cardiovascular Interventions Rudolf Virchow Universitatsklinikum 300 Pasteur Drive der Freien Universitat Berlin Stanford, CA 94305 Augustenburger Platz 1 USA D-13353 Berlin 65, FRG A. Fronek P. Boesiger University of California, San Diego Universitat und ETH Zurich Department of Surgery, 0643 Institut fUr Biomedizinische Technik und School of Medicine Medizinische Informatik Basic Science Building, Rm. 5028 GloriastraBe 35 La Jolla, CA 92093-0643 CH-8092 Zurich USA Swizerland E. T. Fry E. G. Cape Nasser, Smith & Pinkerton Cardiology, Inc. University of Pittsburgh St. Vincent Professional Building Schools of Medicine and Engineering 8402 Hardcourt Road 1249 Benedum Hall Indianapolis, IN 46260 Pittsburgh, PA 15261 USA USA J. Carreira C. Gervas Unidad de Radiologia Vascular e Unidad de Radiologia Vascular e Intervencionista Intervencionista Hospital Nuestra Senora del Pino Hospital Nuestra Senora del Pino Angel Guimera 93 Angel Guimera 93 35005 Las Palmas de Gran Canaria 35005 Las Palmas de Gran Canaria Espana Espana
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