Acknowledgment Leo Schultze Kool, Monique Brink, Gijs Bloemsma, and Maarten Truijers are greatly acknowledged for their help in preparing this chapter. Conventional contrast-enhanced arteriography is no longer considered the standard imaging modality for vascular disease. As with many technologic advances,…
Despite the advances we have made in medical imaging, contrast-enhanced venography has been and is still the “gold standard” for the diagnosis of deep venous thrombosis (DVT) since the early 1970s. Meanwhile, duplex ultrasonography is the most accurate noninvasive testing…
Despite many advances in the quality and availability of less invasive arterial imaging modalities, arteriography remains the “gold standard.” Alternative modalities, such as duplex arterial mapping, computed tomographic angiography (CTA), and magnetic resonance angiography (MRA), are being used with increasing…
Advances in radiation have led to a significant increase in its use for diagnostic, interventional, and therapeutic purposes. With the ever-increasing utilization of endovascular techniques, concern has grown regarding the potential harmful effects of radiation delivered to both the patient…
Introduction Duplex scanning is readily available, noninvasive, and inexpensive. It is the primary means for diagnosis of deep vein thrombosis (DVT) and chronic venous insufficiency (CVI) (see Ch. 148 , Acute Lower Extremity Deep Venous Thrombosis: Presentation, Diagnosis, and Medical…
Venous pathophysiology in the lower extremity manifests as a spectrum of disorders (see Section 23, Chronic Venous Disorders). Reporting standards published first in 1994 and revised in 2004 recognized pathophysiologic assessment as a key feature in assessing patients with chronic…
Introduction Determination of lower limb tissue perfusion in patients with peripheral arterial occlusive disease (PAD) or critical limb-threatening ischemia (CLTI) can be challenging. In addition to the clinical examination, additional diagnostic tools, such as the ankle–brachial index (ABI), toe blood…
Duplex ultrasound (DUS) is an integral component of diagnostic testing for the evaluation and management of arterial disease. This technology, which combines the acquisition of blood flow (pulsed Doppler spectral analysis) and anatomic (B-mode and color Doppler imaging) information, was…
Arterial physiologic testing adds a degree of objectivity to the subjective clinical evaluation of peripheral arterial disease (PAD). The advances in direct physiologic testing of specific arterial sites by duplex scanning and noninvasive imaging evaluation provide the approximate localization of…
Anatomic Considerations The anatomy of the veins and lymphatics provides the basis for understanding the pathophysiology of common disease states. With the primary purpose of the veins to return blood to the heart in a unidirectional fashion and for the…