Guidelines for Noninvasive Vascular Laboratory Testing: A Report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology

Abstract

Accompanying the rapid growth of interest inpercutaneous vascular interventions, there hasbeen increasing interest among cardiologists inperforming noninvasive vascular testing using ul-trasound. In an attempt to provide recommenda-tions on the best practices in vascular laboratorytesting, this report has been prepared by a writinggroup from the American Society of Echocardiog-raphy (ASE) and the Society of Vascular Medicineand Biology. The document summarizes principlesintegral to vascular duplex ultrasound–includingcolor Doppler, spectral Doppler waveform analy-sis, power Doppler, and the use of contrast.Appropriate indications and interpretation of ca-rotid artery, renal artery, abdominal aorta, andperipheral artery ultrasound imaging are de-scribed. A dedicated section summarizes noninva-sive techniques for physiologic vascular testing ofthe lower extremity arteries–including measure-ment of segmental pressures and pulse volumeplethysmography. The use of exercise testing inthe evaluation of peripheral artery disease, ultra-sound evaluation of the lower extremities afterpercutaneous revascularization, and the diagnosisand management of iatrogenic pseudoaneurysm(PSA) is also discussed. A section on the importanttopic of vascular laboratory accreditation is in-cluded. Finally, additional details regarding propertechnique for performance of the various vasculartests and procedures are included in the Appen-dix.