Peripheral Vascular Diagnostic Methods
Angiography and phlebography have traditionally served as the definitive means, respectively, for evaluating disorders of the arteries and veins. Noninvasive techniques assessing physiological parameters of pressure and flow, however, have become critical
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INTRODUCTION DOPPLER ULTRASONOGRAPHY •• CONTINUOUS-WAVE DOPPLER PULSED DOPPLER
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DUPLEX ULTRASONOGRAPHY B-MODE ULTRASOUND COLOR-FLOW DUPLEX . DOPPLER WAVEFORMS PLETHYSMOGRAPHY . . • . AIR PLETHYSMOGRAPHY
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IMPEDANCE PLETHYSMOGRAPHY STRAIN-GAUGE PLETHYSMOGRAPHY PHOTOPLETHYSMOGRAPHY . . • • . . THE NONINVASIVE VASCULAR LABORATORY: LOWER EXTREMITY PERIPHERAL ARTERIAL EXAMINATION PRESSURE MEASUREMENTS ANKLE-BRACHIAL INDEX • • • . . . . • . . .......... .
ToE-BRACHIAL INDEX
LOWER EXTREMITY SEGMENTAL PRESSURE MEASUREMENTS . . . . • • . . . . • . . . DOPPLER ANALOG WAVEFORM ANALYSIS PuLSE VoLUME RECORDINGS EXERCISE TESTING
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LOWER EXTREMITY ARTERIAL DUPLEX ULTRASONOGRAPHY . . . . • . • . . . . LOWER EXTREMITY GRAFT FLOW VELOCITIES UPPER EXTREMITY PERIPHERAL ARTERIAL EXAMINATION UPPER EXTREMITY SEGMENTAL PRESSURE MEASUREMENTS . • • • .
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DIGITAL PHOTOPLETHYSMOGRAPHY COLD CHALLENGE TESTING UPPER EXTREMITY ARTERIAL DUPLEX ULTRASONOGRAPHY EXTRACRANIAL CAROTID ARTERY EXAMINATION ExTRACRANIAL CAROTID ARTERY DuPLEX .•••....•..•.. ULTRASONOGRAPHY DETERMINATION OF ICA STENOSIS • . . . . . OTHER APPLICATIONS OF EXTRACRANIAL CAROTID ARTERY CFDS . • • . . . . • • . . . . . . . . . . . • SPLANCHNIC ARTERY EXAMINATION SPLANCHNIC ARTERY DUPLEX ULTRASONOGRAPHY SPLANCHNIC ARTERY BLOOD FLOW VELOCITIES . . OTHER APPLICATIONS OF SPLANCHNIC ARTERY DUPLEX ULTRASONOGRAPHY THE NONINVASIVE VASCULAR LABORATORY: AcuTE DEEP VENous THROMBOSIS . . . • . LOWER EXTREMITY VENOUS DUPLEX ULTRASONOGRAPHY CHRONIC VENOUS INSUFFICIENCY . . . VENOUS PHOTOPLETHYSMOGRAPHY • . . . . • . . • . VENOUS AIR PLETHYSMOGRAPHY . • . . . • • . . • . VENOUS COLOR-FLOW DUPLEX ULTRASONOGRAPHY . . • • . . . • • . . . . • • . . . • . . . • . .
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INTRODUCTION Angiography and phlebography have traditionally served as the definitive means, respectively, for evaluating disorders of the arteries and veins. Noninvasive techniques assessing physiological parameters of pressure and flow, however, have become critically important in the evaluation and treatment of vascular disease. The objectives in modern noninvasive testing of patients with vascular disease are to confirm the P. Lanzer et al. (eds.), Pan Vascular Medicine © Springer-Verlag Berlin Heidelberg 2002
presence of disease, to provide quantitative, reproducible, physiologic data concerning disease severity, and finally, to document the location and hemodynamic importance of vascular lesions. Two broad categories of noninvasive techniques for evaluation of vascular disorders include Doppler ultrasonography and plethysmography, each with various forms. Each modality has advantages, disadvantages, and limitations. Understanding of both is required for the optimal and cost-effective use of the vascular laboratory in the diagnosis of arterial and venous disorders. In this chapter, basic principles of
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