Noninvasive Vascular Diagnosis

Ali F. AbuRahma • Dennis F. BandykEditors

Patrick A. Stone • Henrik SillesenAssociate Editors

Noninvasive Vascular Diagnosis

A Practical Guide to Therapy

Third Edition

EditorsProf. Ali F. AbuRahma, M.D., RVT, RPVIDepartment of SurgeryRobert C. Byrd Health Science CenterWest Virginia UniversityCharleston, WVUSA

Charleston Area Medical CenterCharleston, WVUSA

Dennis F. Bandyk, M.D.Vascular and Endovascular SurgeryUniversity of California, San DiegoLa Jolla, CAUSA

Associate EditorsPatrick A. Stone, M.D., RVT, RPVIRobert C. Byrd Health Sciences CenterWest Virginia University, Charleston Area Medical CenterCharleston, WVUSA

Henrik Sillesen, M.D., DMScUniversity of CopenhagenDenmark

ISBN 978-1-4471-4004-7 ISBN 978-1-4471-4005-4 (eBook)DOI 10.1007/978-1-4471-4005-4Springer Dordrecht Heidelberg New York London

Library of Congress Control Number: 2012945528

© Springer-Verlag London 2013This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adapta-tion, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law.The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.

Printed on acid-free paper

Springer is part of Springer Science+Business Media (www.springer.com)

To my late Chairman, Dr. James Boland, who was our Chairman for 35 years, a mentor, great educator, exceptional surgeon, and my hero.

Ali F. AbuRahma And to Dr. John Bergan, co-editor of the two previous editions of this textbook, who is a mentor, vascular surgery pioneer, and world renowned leader in vascular surgery.

Ali F. AbuRahma Dennis F. Bandyk

vii

Foreword

The evolution of vascular surgery over the past several years has been truly remarkable. Technologic advances have provided an unprecedented variety of therapeutic options available for the care of the vascular patient. The contemporary vascular specialist today must provide the entire spectrum of care for the patient with circulatory disease, including conventional open surgery, minimally invasive endovascular therapy, and medical management. Fundamental to achieving the optimal outcome for the vascular patient is accurate diagnosis, selection of the most appropriate therapy, and long-term surveillance of the natural history of the disease as well as the outcomes of therapeutic interventions. Crucial to this mission is the vascular non-invasive laboratory. Indeed, not only has the vascular noninvasive laboratory bene fi tted from recent technologic re fi nement, but at no time in its history has it played a more critical role in the management of the patient with vascular disease.

The fi rst vascular noninvasive laboratory was established by surgeons at the Massachusetts General Hospital in 1946, and the evolution of noninvasive vascular laboratory technology over the last six decades has been pioneered by vascular surgical pioneers such as Bergan, Yao, Cranley, Strandness, and Kempczinski. Dr. AbuRahma, who has been a proli fi c clinical inves-tigator and author in the fi eld of vascular noninvasive diagnosis, joined the company of these leaders with publication of the fi rst edition of Noninvasive Diagnosis: A Practical Guide in 2000. The third edition of this book is an encyclopedic treatise on noninvasive vascular diag-nosis, is without question the “gold standard” text in the fi eld, and is a must have volume for any serious practitioner interested in the care of the patient with circulatory disease.

This book provides truly comprehensive coverage of the entire spectrum of noninvasive vascular testing, ranging from conventional noninvasive technology to the latest state-of-the-art advances. The list of part editors and authors of these chapters reads as a “who’s who” of leaders in the fi eld who have combined their unique individual expertise and perspectives with the latest published information in clearly written, beautifully illustrated, and extensively ref-erenced chapters. The totality of vascular noninvasive diagnosis topics are covered, even including regulatory issues which will become an increasingly important issue in our evolving health care system.

For example, today there are more than 10,000 noninvasive vascular laboratories in the United States but less than 25% are actually accredited. The initial part of the book directly addresses the issues of laboratory quality and credentialing. The second part, on vascular hemodynamics, sets the foundation for the clinical parts which follow.

The part on cerebrovascular disease includes 14 chapters which cover not only basic nonin-vasive testing issues, pre-, and post-intervention, but leading edge topics such as transcranial Doppler, intima media thickness, and plaque characterization. These latter modalities will play an increasingly important role in selecting the most appropriate candidates with asymptomatic carotid stenoses for intervention, an issue of growing controversy in contemporary practice and in the future. The comprehensive nature of the part is re fl ected in the inclusion of a chapter on CT and MRA of the carotid arteries.

Likewise, the parts on peripheral arterial disease and venous disease include the entire spec-trum of noninvasive testing from traditional physiologic modalities to the expanding role of Duplex examination in diverse clinical scenarios. The respective roles and the relative

viii Foreword

advantages and disadvantages of each of the available testing modalities are clearly high-lighted for the reader. Whereas mesenteric vascular disease has historically been a diagnosis of exclusion, often established after an extensive work-up pursuing other potential diagnoses, today Duplex ultrasound has become the initial diagnostic modality of choice. Its role in evalu-ating the patient with suspected mesenteric as well as renovascular disease, and in follow-up after intervention, is presented authoritatively.

In an era of increasing pressure for health care cost containment, vascular noninvasive test-ing will play an increasingly important, cost effective, and expanding role in the evaluation of patients with circulatory disease and in many cases will continue to supplant more invasive conventional angiography and expensive radiographic imaging studies. In addition to covering the entire spectrum of conventional noninvasive laboratory examination throughout the body, this text also provides for the reader the most recent information on evolving diagnostic modal-ities such as intravascular ultrasound, three-dimensional imaging, and contrast-enhanced ultrasound.

Noninvasive Vascular Diagnosis : A Practical Guide to Therapy should be required reading and in fact part of the curriculum of every vascular surgery resident, as well as interventional cardiology and interventional radiology trainees with an interest in vascular disease. It will be equally valuable to the experienced practicing health care provider who cares for patients with vascular disease. For the busy clinician, each part of the book concludes with a summary chap-ter on the clinical applications of the information provided in that part. The book even includes a practical chapter on vascular laboratory coding and reimbursement. This book is a truly unique contribution – I know of no other publication in the fi eld that provides such a compre-hensive, well organized, and easily readable presentation of state-of-the-art noninvasive vascu-lar testing.

Bruce A. Perler, MD, MBA Julius H. Jacobson, II Professor of Surgery

The Johns Hopkins University School of Medicine Chief, Division of Vascular Surgery & Endovascular Therapy

Director of the Vascular Noninvasive Laboratory The Johns Hopkins Hospital

ix

Preface

The purpose of the third edition of this popular textbook on noninvasive vascular diagnostics is to highlight recent advances in the investigation of vascular diseases. This new edition is designed to assist physicians and other clinicians in determining the most applicable and prac-tical methods for managing patients with vascular disease in the most cost-effective and ef fi cient manner.

The rapid expansion of this fi eld over the past two decades, and the addition of new diagnos-tic modalities and new applications, justify this third edition. After three decades of maturation of vascular laboratories, from the days of the early pioneers that were in fl uenced by the late Dr. Gene Strandness and other prominent vascular surgeons, a broader group of physicians, including radiologists, neurologists, cardiologists, and internists have become involved in this technology. With this in mind, this new edition is designed to be comprehensive enough to address the needs of all clinicians who are involved in the care of patients with vascular disease.

This new edition has been divided into parts that have been edited by several nationally and internationally prominent experts in the fi eld of noninvasive vascular diagnostics. This is re fl ected, not only by the addition of a new editor, Dr. Dennis Bandyk, but also by the addition of associate editors, Dr. Henrik Sillesen and Dr. Patrick Stone. With the new level of maturity and technologi-cal advances in the fi eld of noninvasive vascular testing, 15 new chapters have been added and the remaining chapters have been extensively revised, many of which have new authors.

The fi rst part on vascular laboratory operations includes a new chapter on quality assurance, which is essential today; while the second part includes a new chapter on vascular hemody-namics by Dr. Henrik Sillesen. The third part on cerebrovascular diagnosis has several new chapters, including the role of duplex ultrasound in carotid screening, computed tomography angiography and magnetic resonance angiography of the carotids, intraoperative ultrasound assessment of carotid endarterectomy and stent angioplasty, intima media thickness measure-ment, and errors and artifacts of carotid ultrasound evaluation.

Part IV, edited by Dr. Dennis Bandyk, also has several new chapters, including duplex uti-lization of radial artery imaging, protocol and mapping techniques prior to hemodialysis access planning, and noninvasive vascular testing in the trauma patient.

The noninvasive diagnosis of venous disorders, Part V, is edited by a new associate editor, Dr. Patrick Stone. Several of these chapters were extensively revised and two new chapters were added on venous duplex ultrasound of the upper extremities and the role of the noninva-sive vascular laboratory in thoracic outlet syndromes.

One new chapter on duplex evaluation after renal intervention was added to Part VI, and Part VII includes new chapters on coding and reimbursement for vascular lab testing and the clinical application of ultrasound guidance in arterial and venous access.

Several modalities are described in this new edition by new authors who were selected based on their extensive knowledge and expertise in these fi elds.

To the contributors, previous authors, and their staff, we, the editors, wish to express our most sincere appreciation. We hope the readers will enjoy this update.

Ali F. AbuRahma, M.D., RVT, RPVIDennis F. Bandyk, M.D.

xi

Acknowledgments

This new edition owes much to our colleagues, who have contributed a great deal, and without their expertise and guidance, this volume would not have become a reality. The editors would like to thank our technical staff for their support, particularly Mona Lett in Charleston, West Virginia, for transcribing and revising the various versions of the chapters and for maintaining contact with contributing authors regarding guidelines and deadlines. We would also like to thank Maynard Chapman in Charleston, West Virginia, for producing some of the illustrations. We also appreciate the efforts of some of my vascular laboratory technicians, including Linda Keffer, Cristyn Coleman, Candace Key, and Kim Riner for their assistance in providing some of the illustrations. Finally, the editors would like to speci fi cally thank Michael D. Sova, Developmental Editor; Grant Weston, Senior Editor, Medicine; and the entire Springer Science + Business Media team for their invaluable support and guidance. Without the support of these people and many others, this new edition would not have seen the light of day.

Ali F. AbuRahma, M.D., RVT, RPVIDennis F. Bandyk, M.D.

xiii

Contents

Part I Vascular Laboratory OperationsSection Editor: Ali F. AbuRahma

1 Improving Quality in Noninvasive Testing by Certificationand Accreditation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3J. Dennis Baker and Anne M. Jones

2 Physician Qualifications in the Clinical Diagnostic Vascular Laboratory . . . . 11M. Ashraf Mansour

3 Quality Assurance of the Vascular Laboratory . . . . . . . . . . . . . . . . . . . . . . . . . 17Cindy Weiland and Marge Hutchisson

Part II Vascular Hemodynamics and Basic Vascular PhysicsSection Editor: Henrik Sillesen

4 Principles of Vascular Ultrasound Physics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Frank R. Miele

5 Vascular Hemodynamics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Henrik Sillesen

Part III Cerebrovascular DiagnosisSection Editor: Ali F. AbuRahma

6 Overview of Cerebrovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57Ali F. AbuRahma

7 Duplex Scanning of the Extracranial Carotid Arteries . . . . . . . . . . . . . . . . . . . 79Ali F. AbuRahma

8 The Role of Color Duplex Scanning in Diagnosing Diseases of the Aortic Arch Branches and Carotid Arteries. . . . . . . . . . . . . . . . . . . . . . . 111Aravinda Nanjundappa, Gianluca Rigatelli, and Clifford T. Araki, and Ali F. AbuRahma

9 Vertebral Artery Ultrasonography. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123Jessica Kepplinger, Kristian Barlinn, and Andrei V. Alexandrov

10 Transcranial Doppler Sonography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133Kristian Barlinn and Andrei V. Alexandrov

11 Ultrasonic Characterization of Carotid Plaques and Its Clinical Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157Alberto Froio, Luca Rossi, Savino Pasquadibisceglie, and Giorgio M. Biasi

xiv Contents

12 Role of Duplex Ultrasound in Carotid Screening . . . . . . . . . . . . . . . . . . . . . . . . 173Faisal Aziz, Robert P. Scissons, and Anthony J. Comerota

13 Duplex Ultrasound Velocity Criteria in Carotid Artery Stenting Patients. . . . 183Brajesh K. Lal

14 Use of TCD in Monitoring Patients During Carotid Artery Stenting. . . . . . . . 189Mark C. Bates

15 Computed Tomography Angiography and Magnetic Resonance Angiography of the Carotids. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201Ali F. AbuRahma and Hisham Bassiouny

16 Intraoperative Ultrasound Assessment of Carotid Endarterectomy and Stent-Angioplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211Paul A. Armstrong, Alexis Powell, and Dennis F. Bandyk

17 Intima Media Thickness Measurement: Definition, Predictive Value on Cardiovascular Events, and Contribution to Cardiovascular Risk Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221Pierre-Jean Touboul

18 Errors and Artifacts of Carotid Ultrasound Evaluation . . . . . . . . . . . . . . . . . . 225K. Wayne Johnston

19 Clinical Implications of the Vascular Laboratory in the Diagnosis of Cerebrovascular Insufficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235Ali F. AbuRahma

Part IV Noninvasive Diagnosis of Peripheral Arterial Disease of the ExtremitiesSection Editor: Dennis F. Bandyk

20 Overview of Peripheral Arterial Disease of the Lower Extremity . . . . . . . . . . 261Ali F. AbuRahma and John E. Campbell

21 Segmental Doppler Pressures and Doppler Waveform Analysis in Peripheral Vascular Disease of the Lower Extremities . . . . . . . . . . . . . . . . . 287Stephen M. Hass and Ali F. AbuRahma

22 Pulse Volume Recording in the Diagnosis of Peripheral Vascular Disease. . . . 303Jeffrey K. Raines and Jose I. Almeida

23 Duplex Scanning for Lower Extremity Arterial Disease . . . . . . . . . . . . . . . . . . 311Paul A. Armstrong, Federico E. Parodi, and Dennis F. Bandyk

24 Duplex Surveillance of Infrainguinal Bypass Grafts . . . . . . . . . . . . . . . . . . . . . 321Patrick A. Stone, Dennis F. Bandyk, and Akhilesh K. Jain

25 Rationale and Benefits of Surveillance After Prosthetic Infrainguinal Bypass Grafts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333Keith D. Calligaro, Sandra C. McAffe-Benett, Kevin J. Doerr, Kathryn Mueller, Stephen Kolakowski, and Matthew J. Dougherty

26 Rationale and Benefits of Surveillance After Percutaneous Transluminal Angioplasty and Stenting of Iliac and Femoral Arteries . . . . . . . . . . . . . . . . . . 339Donald T. Baril and Luke K. Marone

27 Duplex Ultrasound in the Evaluation and Management of Post-Catheterization Femoral Pseudoaneurysms . . . . . . . . . . . . . . . . . . . . . . 347Patrick A. Stone and James R. Campbell II

xvContents

28 Lower Extremity Arterial Mapping: Duplex Ultrasound as an Alternative to Arteriography Prior to Femoral and Popliteal Reconstruction . . . . . . . . . . 355Enrico Ascher, Natalie Marks, Anil P. Hingorani, and Sergio X. Salles-Cunha

29 Noninvasive Diagnosis of Upper Extremity Arterial Disease. . . . . . . . . . . . . . . 365Gregory L. Moneta

30 Duplex Utilization of Radial Artery Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . 379Leon Salem, Jorge Rey, Sean P. Roddy, and R. Clement Darling III

31 Protocol and Mapping Techniques Prior to Hemodialysis Access Planning . . 387Jennifer A. Sexton, Robyn A. Macsata, and Anton N. Sidawy

32 Role of Duplex Ultrasound in Dialysis Access Surveillance. . . . . . . . . . . . . . . . 395Martin R. Back and Dennis F. Bandyk

33 Noninvasive Evaluation for Congenital Arteriovenous Fistulas and Malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407Robert B. Rutherford

34 Noninvasive Vascular Testing for the Trauma Patient . . . . . . . . . . . . . . . . . . . . 417Vincent L. Rowe, John Moos, and Fred A. Weaver

35 Clinical Implications of the Vascular Laboratory in the Diagnosis of Peripheral Arterial Disease. . . . . . . . . . . . . . . . . . . . . . . . . . 425Ali F. AbuRahma

Part V Noninvasive Diagnosis of Venous Disorders of the ExtremitiesSection Editor: Patrick A. Stone

36 Overview of Venous Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451Albeir Y. Mousa

37 Plethysmographic Techniques in the Diagnosis of Venous Disease . . . . . . . . . . 463Shadi Abu-Halimah and William A. Marston

38 Venous Duplex Ultrasound of the Lower Extremity in the Diagnosis of Deep Venous Thrombosis . . . . . . . . . . . . . . . . . . . . . . . . . . . 473M. Ashraf Mansour

39 Venous Duplex Ultrasound of the Upper Extremities . . . . . . . . . . . . . . . . . . . . 483Joann M. Lohr

40 Role of the Noninvasive Vascular Laboratory in Thoracic Outlet Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499Diana Call, Holly L. Grunebach, and Julie Ann Freischlag

41 Venous Imaging for Reflux Using Duplex Ultrasonography . . . . . . . . . . . . . . . 509Dimitrios Karakitsos and Nicos Labropoulos

42 Ultrasound-Guided Cava Filter Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519Bryan T. Fisher Sr and Thomas C. Naslund

43 Intravascular Ultrasound for Venous Stenting and Inferior Vena Cava Filter Insertion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529Peter Neglén

44 The Role of Duplex Ultrasound Before, During, and After Endovenous Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543Peter F. Lawrence

xvi Contents

45 Preoperative Saphenous Vein Mapping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551Melissa D. Shah, R. Clement Darling III, Benjamin B. Chang, Philip S.K. Paty, Paul B. Kreienberg, Sean P. Roddy, Kathleen J. Ozsvath, Manish Mehta, and Dhiraj M. Shah

Part VI Deep Abdominal DopplerSection Editor: Dennis F. Bandyk

46 Ultrasound of the Hepatoportal Circulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565Carol B. Benson and Mary C. Frates

47 Duplex Evaluation of the Renal Arteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 589Marsha M. Neumyer and John Blebea

48 Duplex Evaluation After Renal Intervention . . . . . . . . . . . . . . . . . . . . . . . . . . . 617Shawn H. Fleming and Kimberley J. Hansen

49 Duplex Ultrasonography of the Mesenteric Circulation . . . . . . . . . . . . . . . . . . 625David G. Neschis and William R. Flinn

50 The Role of Color Duplex Ultrasound in Patients with Abdominal Aortic Aneurysms and Peripheral Aneurysms . . . . . . . . . . . . . . . . . . . . . . . . . . 637Shaun M. Stickley and George H. Meier III

51 Role of Color Duplex Ultrasound for Aortic Endografts . . . . . . . . . . . . . . . . . . 649Rabih Chaer, Tracey A. Richardson, and Michel S. Makaroun

Part VII MiscellaneousSection Editor: Ali F. AbuRahma

52 Transcutaneous Oxygen Tension: Principles and Applications . . . . . . . . . . . . . 661Jeffrey L. Ballard

53 Arterial and Venous Intravascular Ultrasound Applications . . . . . . . . . . . . . . 667Edward B. Diethrich and Donald B. Reid

54 Three-Dimensional Vascular Imaging and Power Doppler Angiographic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679Ali F. AbuRahma and Phillip J. Bendick

55 Contrast-Enhanced Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 695Daynene Vykoukal, Javier E. Anaya-Ayala, Alan B. Lumsden, and Mark G. Davies

56 Coding and Reimbursement for Vascular Lab Testing . . . . . . . . . . . . . . . . . . . 717Robert M. Zwolak

57 Clinical Application of Ultrasound Guidance in Arterial and Venous Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 723Patrick A. Stone and Mohit Srivastava

Noninvasive Vascular Laboratory Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 731

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 743

xvii

Contributors

Shadi Abu-Halimah , M.D. Department of Vascular Surgery , UNC Hospitals , Chapel Hill , NC , USA

Ali F. AbuRahma , M.D., RVT, RPVI Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University , Charleston , WV , USA

Charleston Area Medical Center , Charleston , WV , USA

Andrei V. Alexandrov , M.D. Department of Neurology , Comprehensive Stroke Center, University of Alabama at Birmingham Hospital , Birmingham , AL , USA

Jose I. Almeida , M.D, FACS, RPVI, RVT Department of Vascular Surgery , Miami Vein Center , Miami , FL , USA

Javier E. Anaya-Ayala , M.D. Department of Cardiovascular Surgery , Methodist DeBakey Heart & Vascular Center , Houston , TX , USA

Clifford T. Araki , Ph.D., RVT Department of Medical Imaging Sciences , School of Health Related Professions, University of Medicine and Dentistry of New Jersey , Newark , NJ , USA

Paul A. Armstrong , D.O. Division of Vascular and Endovascular Surgery , University of South Florida, College of Medicine , Tampa , FL , USA

Enrico Ascher , M.D. Department of Surgery , Mount Sinai School of Medicine , New York , NY , USA

The Vascular Institute of New York , Brooklyn , NY , USA

Faisal Aziz , M.D., RVT, RPVI Jobst Vascular Institute, The Toledo Hospital , Hershey , PA , USA

Section of Vascular Surgery, Department of Surgery , Penn State Hershey College of Medicine , Hershey , PA , USA

Martin R. Back , M.D., RPVI, RVT Division of Vascular and Endovascular Surgery , University of South Florida, College of Medicine , Tampa , FL , USA

J. Dennis Baker , M.D. Department of Surgery , David Geffen School of Medicine at UCLA , Los Angeles , CA , USA

Jeffrey L. Ballard , M.D. Department of Vascular Surgery , St. Joseph Hospital , Orange , CA , USA

Dennis F. Bandyk , M.D. Department of Vascular and Endovascular Surgery , UC San Diego , La Jolla , CA , USA

Donald T. Baril , M.D. Division of Vascular and Endovascular Surgery, Department of Surgery , University of Massachusetts Medical School , Worcester , MA , USA

xviii Contributors

Kristian Barlinn , M.D. Department of Neurology , Dresden University Stroke Center, University of Technology Dresden , Dresden, Saxony , Germany

Department of Neurology , Comprehensive Stroke Center, University of Alabama at Birmingham Hospital , Dresden, Saxony , Germany

Hisham Bassiouny , M.D., FACS Section of Vascular Surgery and Endovascular Therapy , The University of Chicago , Chicago , IL , USA

Mark C. Bates , M.D., FACC, FSCAI Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Phillip J. Bendick , Ph.D. Division of Vascular Surgery , William Beaumont Hospital , Royal Oak , MI , USA

Carol B. Benson , M.D. Department of Radiology , Harvard Medical School , Boston , MA , USA

Department of Radiology , Brigham and Women’s Hospital , Boston , MA , USA

Giorgio M. Biasi , M.D. Department of Surgical Sciences , University of Milano Bicocca , Monza , Italy

Vascular Surgery Unit , San Gerardo Teaching Hospital , Monza , Italy

John Blebea , M.D. Department of Surgery , University Hospitals of Cleveland, Case Western Reserve University School of Medicine , Cleveland , OH , USA

Diana Call , BS, RVT Division of Vascular Surgery and Endovascular Therapy , John Hopkins Hospital , Baltimore , MD , USA

Keith D. Calligaro , M.D. Section of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

John E. Campbell , M.D. Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

James R. Campbell II, M.D. Department of Surgery and Medicine , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Rabih Chaer , M.D. Division of Vascular Surgery , PUH , Pittsburgh , PA , USA

Benjamin B. Chang , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Anthony J. Comerota , M.D., RVT, FACS, FACC Section of Vascular Surgery , University of Michigan , Toledo , OH , USA

Jobst Vascular Institute, The Toledo Hospital , Toledo , OH , USA

R. Clement Darling III, M.D. Department of Vascular Surgery , Albany Medical Center Hospital; Albany Medical College , Albany , NY , USA

The Vascular Group , Albany Medical College , Albany , NY , USA

Mark G. Davies , M.D., Ph.D., M.B.A. Department of Surgery , Weill Medical College at Cornell University , Houston , TX , USA

Department of Cardiovascular Surgery , Methodist DeBakey Heart & Vascular Center , Houston , TX , USA

Department of Research and Education , Methodist DeBakey Heart & Vascular Center , Houston , TX , USA

xixContributors

Edward B. Diethrich , M.D. Arizona Heart Hospital & Foundation , Phoenix , AZ , USA

Kevin J. Doerr , BS, RVT Department of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

Matthew J. Dougherty , M.D. Section of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

Bryan T. Fisher Sr M.D. Department of Vascular Surgery , Vanderbilt University Medical Center , Nashville , TN , USA

Shawn H. Fleming , M.D. Department of Vascular and Endovascular Surgery , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA

William R. Flinn , M.D. Division of Vascular Surgery , University of Maryland School of Medicine , Baltimore , MD , USA

Mary C. Frates , M.D. Department of Radiology , Harvard Medical School , Boston , MA , USA

Department of Radiology , Brigham and Women’s Hospital , Boston , MA , USA

Julie Ann Freischlag , M.D. Department of Surgery , John Hopkins Hospital , Baltimore , MD , USA

Alberto Froio , M.D. Department of Surgical Sciences , San Gerardo Teaching Hospital, University of Milano Bicocca , Monza , Italy

Holly L. Grunebach , MMS, MSPH Department of Surgery , Johns Hopkins Hospital , Baltimore , MD , USA

Kimberley J. Hansen , M.D. Department of Vascular and Endovascular Surgery , Wake Forest Baptist Medical Center , Winston-Salem , NC , USA

Stephen M. Hass , M.D. Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Anil P. Hingorani , M.D. Division of Vascular Surgery , Maimonides Medical Center , Brooklyn , NY , USA

Marge Hutchisson , RVT, RDCS Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), Intersocietal Accreditation Commission , Ellicott City , MD , USA

Akhilesh K. Jain , M.D. Section of Vascular Surgery , Yale University , New Haven , CT , USA

K. Wayne Johnston , M.D., FRCS(C) Department of Vascular Surgery , University of Toronto, Toronto General Hospital , Toronto , ON , Canada

Anne M. Jones , RN, BSN, RVT, RDMS, FSVU, FSDMS Department of Neurology and Neurosciences , Medical University of South Carolina (MUSC) , Charleston , SC , USA

Dimitrios Karakitsos , M.D., Ph.D., MRCP Intensive Care Unit , General State Hospital of Athens , Athens , Greece

Jessica Kepplinger , M.D. Department of Neurology , Dresden University Stroke Center, University of Technology Dresden , Dresden, Saxony , Germany

Stephen Kolakowski , M.D. Section of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

Paul B. Kreienberg , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Nicos Labropoulos , Ph.D. Division of Vascular Surgery, Department of Surgery , Stony Brook University Medical Center , Stony Brook , NY , USA

xx Contributors

Brajesh K. Lal , M.D., FACS Department of Vascular Surgery , Baltimore VA Medical Center , Baltimore , MD , USA

Center for Vascular Diagnostics, University of Maryland Medical Center , Baltimore , MD , USA

Department of Surgery , University of Maryland Medical center , Baltimore , MD , USA

Peter F. Lawrence , M.D. Department of Surgery , Ronald Reagan UCLA Medical Center , Los Angeles , CA , USA

Joann M. Lohr , M.D., FACS, RVT Department of Vascular Surgery , Good Samaritan Outpatient Center , Cincinnati , OH , USA

Good Samaritan Hospital , Cincinnati , OH , USA

Alan B. Lumsden , M.D. Department of Surgery , Weill Medical College at Cornell University , Houston , TX , USA

Department of Cardiovascular Surgery , Methodist DeBakey Heart & Vascular Center , Houston , TX , USA

Robyn A. Macsata , M.D. Department of Surgery , Washington DC VA Medical Center , Washington , DC , USA

Michel S. Makaroun , M.D. Department of Vascular Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA

M. Ashraf Mansour , M.D., RVT, FACS Spectrum Health , Grand Rapids , MI , USA

Department of Cardiovascular Surgery , Michigan State University , Grand Rapids , MI , USA

Natalie Marks , M.D. Brooklyn , NY , USA

Luke K. Marone , M.D. Division of Vascular Surgery, Department of Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA

William A. Marston , M.D. Vascular Surgery Division, Department of Surgery , UNC Hospitals , Chapel Hill , NC , USA

Sandra C. McAffe-Benett , BS, RVT Department of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

Manish Mehta , M.D., MPH Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

George H. Meier III, M.D., RVT, FACS Division of Vascular Surgery, Department of Surgery , University Hospital , Cincinnati , OH , USA

Frank R. Miele , MSEE Pegasus Lectures, Inc. , Forney , TX , USA

Gregory L. Moneta , M.D. Department of Vascular Surgery , Oregon Health and Science University , Portland , OR , USA

John Moos , M.D. Division of Vascular Surgery, Department of Surgery , Keck School of Medicine at the University of Southern California , Los Angeles , CA , USA

Albeir Y. Mousa , M.D. Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Kathryn Mueller , BS, RVT Department of Vascular Surgery , Pennsylvania Hospital , Philadelphia , PA , USA

xxiContributors

Aravinda Nanjundappa , M.D., RVT, FACC, FSCAI Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Thomas C. Naslund , M.D. Department of Vascular Surgery , Vanderbilt University Medical Center , Nashville , TN , USA

Peter Neglén , M.D., Ph.D. Department of Vascular Surgery , Trimiklini, Limassol , Cyprus

David G. Neschis , M.D. Department of Surgery , The Maryland Vascular Center, Baltimore Washington Medical Center, University of Maryland School of Medicine , Baltimore , MD , USA

Marsha M. Neumyer , BS, RVT Vascular Diagnostic Educational Services , Vascular Resource Associates , Harrisburg , PA , USA

Kathleen J. Ozsvath , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Federico E. Parodi , M.D. Division of Vascular and Endovascular Surgery , University of South Florida, College of Medicine, Tampa General Hospital , Tampa , FL , USA

Savino Pasquadibisceglie , M.D. Department of Surgical Sciences , San Gerardo Teaching Hospital, University of Milano Bicocca , Monza , Italy

Philip S. K. Paty , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Alexis Powell , M.D. Department of Surgery , University of South Florida, School of Medicine , Tampa , FL , USA

Jeffrey K. Raines , MME, Ph.D. Department of Surgery , University of Miami Hospital and Clinics , Homestead , FL , USA

Donald B. Reid , M.D., FRCS Department of Vascular and Endovascular Surgery , Wishaw Hospital , Scotland , UK

Jorge Rey , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Tracey A. Richardson , AS, RDMS, RVT Department of Vascular Surgery , University of Pittsburgh Medical Center , Pittsburgh , PA , USA

Gianluca Rigatelli , M.D., Ph.D. Department of Cardiovascular Diagnosis and Endoluminal Interventions , Rovigo General Hospital , Rovigo , Italy

Sean P. Roddy , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Luca Rossi , M.D. Department of Surgical Sciences , San Gerardo Teaching Hospital, University of Milano Bicocca , Monza , Italy

Vincent L. Rowe , M.D., FACS Division of Vascular Surgery, Department of Surgery , Keck School of Medicine at the University of Southern California , Los Angeles , CA , USA

Healthcare Consultation Center II , Los Angeles , CA , USA

Robert B. Rutherford , M.D. Department of Surgery , University of Colorado Medical Center , Corpus Christi , TX , USA

Leon Salem , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

xxii Contributors

Sergio X. Salles-Cunha , Ph.D., RVT, FSVU Department of Imagenology , Itanhaém, São Paulo , SP , Brazil

Robert P. Scissons , RVT, FSVU Jobst Vascular Laboratory , Jobst Vascular Institute, The Toledo Hospital , Toledo , OH , USA

Jennifer A. Sexton , M.D. Georgetown University Hospital, Washington Hospital Center , Washington , DC , USA

Dhiraj M. Shah , MD Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Melissa D. Shah , M.D. Department of Vascular Surgery , Albany Medical Center Hospital , Albany , NY , USA

Anton N. Sidawy , M.D., MPH Department of Surgery , George Washington University Hospital , Washington , DC , USA

Henrik Sillesen , M.D., DMSc Department of Vascular Surgery , Rigshospitalet, University of Copenhagen , Copenhagen , Denmark

Mohit Srivastava , M.D. Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Shaun M. Stickley , M.D. Division of Vascular Surgery, Department of Surgery , University Hospital , Cincinnati , OH , USA

Patrick A. Stone , M.D., RVT, RPVI Department of Surgery , Robert C. Byrd Health Sciences Center, West Virginia University, Charleston Area Medical Center , Charleston , WV , USA

Pierre-Jean Touboul , M.D. INSERM U698, Neurology and Stroke Center, Bichat University Hospital and Medical School , Paris , France

Daynene Vykoukal , Ph.D. Department of Cardiovascular Surgery , Methodist DeBakey Heart & Vascular Center , Houston , TX , USA

Fred A. Weaver , M.D., FACS, MMM Division of Vascular Surgery, Department of Surgery , Keck Medical Center of USC , Los Angeles , CA , USA

Cindy Weiland , RVT Department of Quality Assurance , Intersocietal Accreditation Commission , Ellicott City , MD , USA

Robert M. Zwolak , M.D., Ph.D. Section of Vascular Surgery , Dartmouth-Hitchcock Medical Center , Lebanon , NH , USA